Gayle Louise Diller, D.O.
Individual provider Active NPI Internal Medicine Physician · Pafb, FL
NPI 1043299704 · NPPES record last updated Sep 2, 2011
Key facts
- NPI
- 1043299704
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- OS012475 (PA)
- Practice address
- 1381 South Patrick Drive
45 MDG/Family Health Clinic
Pafb, FL 32925 - Phone
- (321) 494-1146
- NPI assigned
- Jan 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS012475 | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OS012475 | PA | Yes |
Addresses
Primary practice location
1381 South Patrick Drive
45 MDG/Family Health Clinic
Pafb, FL 32925
Mailing address
1381 South Patrick Drive
45 MDG/Family Health Clinic
Pafb, FL 32925
Other names
- Gayle Louise Diller
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.