Provider Demographics
NPI:1619969755
Name:PEELE, DIANE KAY (DC)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:KAY
Last Name:PEELE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 SW 7TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-6458
Mailing Address - Country:US
Mailing Address - Phone:352-375-3668
Mailing Address - Fax:
Practice Address - Street 1:305 SW 7TH TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-6458
Practice Address - Country:US
Practice Address - Phone:352-375-3668
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7707111N00000X
FLPN1047261164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70531OtherBCBSFL PROVIDER ID
FL265679OtherAVMED PROVIDER ID
FL265679OtherAVMED PROVIDER ID
FL70531OtherBCBSFL PROVIDER ID