Provider Demographics
NPI:1265436018
Name:DIABETES CARE CENTER, INC
Entity type:Organization
Organization Name:DIABETES CARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUSIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-869-7822
Mailing Address - Street 1:14100 FIVAY RD
Mailing Address - Street 2:STE 250
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-7151
Mailing Address - Country:US
Mailing Address - Phone:727-869-7822
Mailing Address - Fax:727-862-0934
Practice Address - Street 1:14100 FIVAY RD
Practice Address - Street 2:STE 250
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7151
Practice Address - Country:US
Practice Address - Phone:727-869-7822
Practice Address - Fax:727-862-0934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044520207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21131AMedicare PIN
FL21131Medicare PIN
FL21131BMedicare PIN