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General NPI Number Information
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NPI Number | 1174697569
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Entity Type | Individual
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Provider Name | MICHAEL A DIAMOND M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 9220SW72ND ST 200
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City | MIAMI
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State | FL
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Zip | 33173-3259
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Country | US
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Telephone | 305-279-2256
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Fax | 305-598-0245
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Provider Business Mailing Address
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Address Line | 9220SW72ND ST 200
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City | MIAMI
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State | FL
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Zip | 33173-3259
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Country | US
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Telephone | 305-279-2256
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Fax | 305-598-0245
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME43348
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License Number State | FL
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