MEDICARE: MRS. DIANNA JEAN BORRMANN R.M.A.

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	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1346559929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIANNA JEAN BORRMANN R.M.A.

Provider Business Mailing Address
First Line	:	512 S ADAMS ST
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-4345
Country	:	US
Telephone Number	:	352-400-5103
Fax Number	:	352-637-0106

Provider Business Practice Location Address
First Line	:	512 S ADAMS ST
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-4345
Country	:	US
Telephone Number	:	352-400-5103
Fax Number	:	352-637-0106

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

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	09/30/2010

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