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NPI 1275542474

NPI 1275542474 : DIANA CALDERONE MD : LAND O LAKES, FL

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General NPI Number Information
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    NPI Number           |    1275542474
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    Entity Type          |    Individual 
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    Provider Name        |    DIANA CALDERONE MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/05/2006
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    Last Update Date     |    08/25/2021
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Provider Practice Location Address
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    Address Line         |    2100 VIA BELLA BLVD SUITE 101
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    City                 |    LAND O LAKES
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    State                |    FL
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    Zip                  |    34639-5403
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    Country              |    US
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    Telephone            |    813-948-1498
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    Fax                  |    813-355-5040
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Provider Business Mailing Address
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    Address Line         |    38135 MARKET SQUARE 
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    City                 |    ZEPHYRHILLS
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    State                |    FL
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    Zip                  |    33542
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    Country              |    US
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    Telephone            |    813-528-4975
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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        |    207N00000X
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    Taxonomy Name        |    Dermatology Physician
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    License Number       |    ME63051
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    License Number State |    FL
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