MEDICARE: DIANE ASHLEY PA-C

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	363A00000X	Physician Assistant	PA3260	FL

General Provider Information

NPI Number	:	1821087552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE ASHLEY PA-C

Provider Business Mailing Address
First Line	:	18384 102ND WAY S
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33498-1663
Country	:	US
Telephone Number	:	561-350-3029
Fax Number	:

Provider Business Practice Location Address
First Line	:	18384 102ND WAY S
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33498-1663
Country	:	US
Telephone Number	:	561-350-3029
Fax Number	:

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

Provider Enumeration Date	:	10/15/2005
Last Update Date	:	10/06/2022

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Directions to “ DIANE ASHLEY PA-C” Practice Location

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