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General NPI Number Information
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NPI Number | 1184152886
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Entity Type | Individual
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Provider Name | JACK DIAMOND RPH
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Gender | Male
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Dates
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Enumeration Date | 05/25/2017
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 27225 STATE ROAD 56
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-8832
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Country | US
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Telephone | 813-973-7035
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Fax | 813-973-7396
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Provider Business Mailing Address
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Address Line | 27356 GOLF COURSE LOOP
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-3703
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Country | US
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Telephone | 813-973-7035
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS24807
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License Number State | FL
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