Provider Demographics
NPI:1649298985
Name:DIDIO, ADAM S (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:S
Last Name:DIDIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 12868
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33733-2868
Mailing Address - Country:US
Mailing Address - Phone:727-532-1355
Mailing Address - Fax:727-266-4928
Practice Address - Street 1:2200 W BAY DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-1929
Practice Address - Country:US
Practice Address - Phone:727-518-2977
Practice Address - Fax:727-518-0010
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME943002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275807500Medicaid
FLME94300OtherFLORIDA MEDICAL LICENSE
NY225702-1OtherNEW YORK MEDICAL LICENSE
FL275807500Medicaid