MEDICARE: DR. PAUL C DIAMOND 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	207Q00000X	Family Medicine Physician	OS0004136	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	:	1427032796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL C DIAMOND D.O.

Provider Business Mailing Address
First Line	:	9970 CENTRAL PARK BLVD N
Second Line	:	SUITE 205
City	:	BOCA RATON
State	:	FL
Zip	:	33428-2236
Country	:	US
Telephone Number	:	561-487-1203
Fax Number	:	561-487-1251

Provider Business Practice Location Address
First Line	:	9970 CENTRAL PARK BLVD N
Second Line	:	SUITE 205
City	:	BOCA RATON
State	:	FL
Zip	:	33428-2236
Country	:	US
Telephone Number	:	561-487-1203
Fax Number	:	561-487-1251

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	09/24/2010

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