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NPI Code Detail

MEDICARE: THE DIVERSITY INITIATIVE

MEDICARE: THE DIVERSITY INITIATIVE
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
1251V00000XVoluntary or Charitable Agency

Other Identifiers

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

General Provider Information

NPI Number : 1942624929
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE DIVERSITY INITIATIVE
Provider Business Mailing Address
First Line : 9250 BAY PLAZA BLVD STE 310
Second Line :
City : TAMPA
State : FL
Zip : 33619-4465
Country : US
Telephone Number : 813-644-6829
Fax Number : 813-644-3830
Provider Business Practice Location Address
First Line : 9250 BAY PLAZA BLVD STE 310
Second Line :
City : TAMPA
State : FL
Zip : 33619-4465
Country : US
Telephone Number : 813-644-6829
Fax Number : 813-644-3830
Authorized Official
Title or Position : PRESIDENT
Name : MR. JOHN PRIBANIC
Credential : BA
Telephone Number : 813-850-4736
Provider Enumeration Date : 02/11/2014
Last Update Date : 02/11/2014

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Directions to “THE DIVERSITY INITIATIVE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.