Provider Demographics
NPI:1720038615
Name:DIOMEDE, DAWN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:DIOMEDE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 PRIMERA BLVD
Mailing Address - Street 2:SUITE #135
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2112
Mailing Address - Country:US
Mailing Address - Phone:407-321-0085
Mailing Address - Fax:407-328-7658
Practice Address - Street 1:735 PRIMERA BLVD
Practice Address - Street 2:SUITE #135
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2112
Practice Address - Country:US
Practice Address - Phone:407-321-0085
Practice Address - Fax:407-328-7658
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2152142363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics