Provider Demographics
NPI:1003924671
Name:DIANA ESTORINO
Entity Type:Organization
Organization Name:DIANA ESTORINO
Other - Org Name:EXPERT NEUROTECHS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTORINO
Authorized Official - Suffix:
Authorized Official - Credentials:BA, RNCST, REEG/
Authorized Official - Phone:727-520-1500
Mailing Address - Street 1:PO BOX 20072
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-0072
Mailing Address - Country:US
Mailing Address - Phone:727-520-1500
Mailing Address - Fax:727-520-1588
Practice Address - Street 1:5800 49TH ST N
Practice Address - Street 2:SUITE 202
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2146
Practice Address - Country:US
Practice Address - Phone:727-520-1500
Practice Address - Fax:727-520-1588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV2196OtherBLUE CROSS
FLE1860Medicare PIN