Raina Diedrick, PHYSICIAN ASSISTANT
NPI #1073895132 in Fort Lauderdale, Florida
Provider Information
- NPI Number
- 1073895132
- Entity Type
- Individual
- Name
- Raina Diedrick, PHYSICIAN ASSISTANT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PHYSICIAN ASSISTANT
- Enumeration Date
- Sep 15, 2011
- Last Updated
- Jun 10, 2020
Practice Location
- Address
- 1995 E OAKLAND PARK BLVD
- Address 2
- STE 310
- City
- Fort Lauderdale
- State
- Florida
- ZIP Code
- 33306-1138
- Phone
- (954) 791-6146
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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