Diana K Mullin
Individual provider Active NPI Developmentally Disabled Services Day Training Agency · Bushnell, FL
NPI 1205083268 · NPPES record last updated Aug 21, 2008
Key facts
- NPI
- 1205083268
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmentally Disabled Services Day Training Agency 251C00000X
- License
- 686124596 (FL)
- Practice address
- 9325 CR 622 G
Bushnell, FL 33513 - Phone
- (352) 568-2207
- NPI assigned
- Aug 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 686124596 | FL | MD | Developmentally Disabled Services Day Training Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | 686124596 | FL | Yes |
Addresses
Primary practice location
9325 CR 622 G
Bushnell, FL 33513
Mailing address
9325 CR 622 G
Bushnell, FL 33513
Phone (352) 568-2207
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 686124596 | Medicaid | FL |
Other providers in Bushnell, FL
- Brigitte Mitchell
- Gwendolyn Denese Mobley
- Noelle Mooneyham
- Sheri F Morgan
- Sarah J Moyer
- Vijaya L Nagabhairu
- Raihna Maklay Newcomb
- Desirae Newell
- Joseph Brent Novak
- Osprey Nursing and Rehabilitation, LLC
All providers in Bushnell, FL · Developmentally Disabled Services Day Training Agency in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2008. 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.