Provider Demographics
NPI:1326033895
Name:DIENER, HOWARD DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:DAVID
Last Name:DIENER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3930 BEE RODGE ROAD
Mailing Address - Street 2:BLDG C. STE C
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1207
Mailing Address - Country:US
Mailing Address - Phone:941-923-8353
Mailing Address - Fax:941-925-7064
Practice Address - Street 1:3920 BEE RIDGE RD
Practice Address - Street 2:BLDG C, STE C
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1207
Practice Address - Country:US
Practice Address - Phone:941-923-8353
Practice Address - Fax:941-925-7064
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0049428174400000X
NC116169207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL045805800Medicaid
NC5917580Medicaid
FLD50563Medicare UPIN
FL045805800Medicaid
FL045805800Medicaid