Provider Demographics
NPI:1639671944
Name:SCHMITT, DIANA LILLIANN
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LILLIANN
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 MEDICAL BLVD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-4098
Mailing Address - Country:US
Mailing Address - Phone:941-475-1234
Mailing Address - Fax:
Practice Address - Street 1:701 MEDICAL BLVD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-4098
Practice Address - Country:US
Practice Address - Phone:941-475-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator