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General NPI Number Information
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NPI Number | 1346630043
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Entity Type | Organization
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Legal Business Name | MICHAEL A. DIAMOND M.D. PA
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 9220 SW 72ND 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 | 9220 SW 72ND 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 | PHYSICIAN
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Name | DR. MICHAEL ALAN DIAMOND
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Credential | M.D.
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Telephone | 305-279-2256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME 43348
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License Number State | FL
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