MEDICARE: ELIZABETH DIAMOND ARNP

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	363L00000X	Nurse Practitioner	ARNP 1676812	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	E3625V	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y032W	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952494171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH DIAMOND ARNP

Provider Business Mailing Address
First Line	:	1285 CREEKSIDE BLVD E UNIT 102
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-0595
Country	:	US
Telephone Number	:	239-624-8070
Fax Number	:	239-624-8071

Provider Business Practice Location Address
First Line	:	1285 CREEKSIDE BLVD E UNIT 102
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34109-0595
Country	:	US
Telephone Number	:	239-624-8070
Fax Number	:	239-624-8071

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/21/2022

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