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NPI Code Detail

MEDICARE: DR. DIANA BRONSTEIN DDS

MEDICARE: DR. DIANA BRONSTEIN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0300XPeriodonticsDN18020FL

General Provider Information

NPI Number : 1134328172
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIANA BRONSTEIN DDS
Provider Business Mailing Address
First Line : 16669 SUNBURST LAKE ST
Second Line :
City : WIMAUMA
State : FL
Zip : 33598-5566
Country : US
Telephone Number : 267-391-9294
Fax Number :
Provider Business Practice Location Address
First Line : 5580 CORTEZ RD W FL 34210
Second Line :
City : BRADENTON
State : FL
Zip : 34210-2817
Country : US
Telephone Number : 267-391-9294
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2007
Last Update Date : 12/31/2025

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Directions to “ DR. DIANA BRONSTEIN DDS” Practice Location

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