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General NPI Number Information
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NPI Number | 1487409561
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Entity Type | Individual
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Provider Name | ELIZABETH DIEKMAN PA
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Gender | Female
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 1300 MEDICAL DR
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4646
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Country | US
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Telephone | 850-216-0100
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Fax | 850-201-4834
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Provider Business Mailing Address
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Address Line | 1607 SAINT JAMES CT STE 1
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5352
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Country | US
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Telephone | 850-431-7289
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9118833
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License Number State | FL
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