Provider Demographics
NPI:1790323103
Name:DILONE, EDWIN ERNESTO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:ERNESTO
Last Name:DILONE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5218 ROLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-7712
Mailing Address - Country:US
Mailing Address - Phone:208-519-2827
Mailing Address - Fax:
Practice Address - Street 1:5218 ROLLINS AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-7712
Practice Address - Country:US
Practice Address - Phone:208-519-2827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW212391041C0700X
FLISW14827104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW21239OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH
FLISW14827OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH