Individual provider Active NPI

Diana Patricia Martin, M.D.

  • Pediatric Allergy/Immunology Physician
  • Tampa, FL
National Provider Identifier
1780688432
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
ME88573 Issued in FL
Practice address
4503 N Armenia Ave
Tampa, FL 33603-2745
Phone
(813) 873-1177
Fax
(813) 873-1166
NPI assigned
Jun 10, 2005
Reactivated
Mar 24, 2006
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology Physician 2080P0201X ME88573 FL Primary

Addresses

Primary practice location

4503 N Armenia Ave
Tampa, FL 33603-2745

Mailing address

1800 Dr Martin Luther King Jr St N
St Petersburg, FL 33704-4222
Phone (727) 865-4288

Other identifiers 2

IdentifierTypeStateIssuer
268116101MedicaidFL
268116100MedicaidFL

Other names 1

  • Diana P Jerez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040708000115 FL Practitioner - Allergy/Immunology 2466439609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4503 N Armenia Ave
Tampa, FL 33603-2745
Phone (813) 873-1177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME88573FLMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Pediatric Associates LLC CurrentSince Jul 1, 2014 Accepting new patients
Florida Pediatric Associates, LLC CurrentSince Jul 1, 2014 Accepting new patients
John Drygas LLC Past Accepting new patients
Pediatric Physician Services, Inc. Past Accepting new patients

Locations

19030 N Dale Mabry Hwy
Lutz, FL 33548

19039 N Dale Mabry Hwy
Lutz, FL 33548
Phone (813) 873-1177

1800 Dr Martin Luther King St N
St Petersburg, FL 33704
Phone (727) 821-2121

1918 W Mlk Blvd
Tampa, FL 33607
Phone (813) 582-5203

4503 N Armenia Ave
Tampa, FL 33603
Phone (813) 873-1177

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1780688432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337044222",
            "telephone_number": "727-865-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4503 N ARMENIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336032745",
            "telephone_number": "813-873-1177",
            "fax_number": "813-873-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DIANA",
        "middle_name": "PATRICIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "FL",
            "license": "ME88573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268116101",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268116100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "JEREZ",
            "middle_name": "P",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.