MEDICARE: DR. ERIKA DIOGENE D.O.

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
1	208000000X	Pediatrics Physician	OS13874	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306283924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIKA DIOGENE D.O.

Provider Business Mailing Address
First Line	:	5200 BABCOCK ST NE STE 302
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-4648
Country	:	US
Telephone Number	:	321-285-7212
Fax Number	:	321-250-2038

Provider Business Practice Location Address
First Line	:	5200 BABCOCK ST NE STE 302
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-4648
Country	:	US
Telephone Number	:	321-285-7212
Fax Number	:	321-250-2038

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2013
Last Update Date	:	11/15/2023

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