=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326033895
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HOWARD DAVID DIENER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/12/2005
-----------------------------------------------------
Last Update Date | 08/29/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3920 BEE RIDGE RD BLDG C, STE C
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-1207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-923-8353
-----------------------------------------------------
Fax | 941-925-7064
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3930 BEE RODGE ROAD BLDG C. STE C
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34233-1207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-923-8353
-----------------------------------------------------
Fax | 941-925-7064
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | ME0049428
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | 116169
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------