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Provider Information for 1033154554

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. LINDA L. DIEDRIECH M.D.

Gender: FEMALE

Individual NPI: 1033154554

Calendar   Last Updated:  2018-12-20
  Certification Date: 

Details

Name Value
NPI 1033154554
Enumeration Date 2006-06-18
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 4705 ALT 19 STE B
PALM HARBOR, FL 34683-1424
United States

Phone: 727-935-6477 | Fax: 727-935-6478
View Map External Link
Primary Practice Address 4705 ALT 19 STE B
PALM HARBOR, FL 34683-1424
United States

Phone: 727-935-6477 | Fax: 727-935-6478
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207R00000X - Internal Medicine FL ME83838