Diane Walder Mdpa

Organization Active NPI Specialist · Bay Harbor Islands, FL

NPI 1013940774 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1013940774
Entity type
Organization (NPI type 2)
Primary specialty
Specialist 174400000X
License
ME39412 (FL)
Legal business name
DIANE WALDER MDPA
Practice address
1111 Kane Concourse
Suite 100
Bay Harbor Islands, FL 33154-2029
Phone
(305) 866-2177
Fax
(305) 866-5302
NPI assigned
Jul 8, 2006
Organization subpart
No

Authorized official

Name
Diane Walder, MD
Title
President
Phone
(305) 866-2177

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist
Group: 193400000X SINGLE SPECIALTY GROUP
174400000X ME39412 FL Yes

Addresses

Primary practice location

1111 Kane Concourse
Suite 100
Bay Harbor Islands, FL 33154-2029

Mailing address

1111 Kane Concourse
Suite 100
Bay Harbor Islands, FL 33154-2029
Phone (305) 866-2177

Other providers in Bay Harbor Islands, FL

All providers in Bay Harbor Islands, FL · Specialist in Florida

Sources for this page

Verify at the official NPI Registry.