Provider Demographics
NPI:1851333033
Name:DIOKNO, ROSANA MACKENZIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSANA
Middle Name:MACKENZIE
Last Name:DIOKNO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROSANA
Other - Middle Name:MACKENZIE
Other - Last Name:DIOKNO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 CHILDREN'S WAY # 512-1
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-364-2963
Practice Address - Street 1:1 CHILDREN'S WAY # 512-1
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202
Practice Address - Country:US
Practice Address - Phone:501-364-1100
Practice Address - Fax:501-364-2963
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85802208000000X
ARE-1378208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265351600Medicaid
AR5K639Medicare PIN
51968ZMedicare PIN
G02114Medicare UPIN