John a Dietrick M D P L

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME88224 Issued in FL

Legal business name

JOHN A DIETRICK M D P L

Practice address

13801 Bruce B Downs Blvd
Suite 104
Tampa, FL 33613-3946

Phone

(813) 971-8883

Fax

(813) 971-2491

NPI assigned

Jan 2, 2008

Organization subpart

No

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

Authorized official

Name

Dr. John A Dietrick III, MDNPI 1124103528

Title

Owner

Phone

(813) 971-8883

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Dietrick III, M.D.

  • Surgery Physician
  • Tampa, FL
  • NPI 1124103528
  NPD (past) Authorized official

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1982889507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 BRUCE B DOWNS BLVD",
            "address_2": "SUITE 104",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133946",
            "telephone_number": "813-971-8883",
            "fax_number": "813-971-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 BRUCE B DOWNS BLVD",
            "address_2": "SUITE 104",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133946",
            "telephone_number": "813-971-8883",
            "fax_number": "813-971-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A DIETRICK M D P L",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "DIETRICK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-971-8883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME88224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Anthony Joerger
• Joey S Ancheta LLC
• Liety Joglar Gonzalez
• Phillip Mitchell Johansen, MD
• Christian Henrik Johansson, PA-C
• John Baker MD PA
• John C Brock MD PL
• John Cottam MD PA
• John D Dos Passos II DMD PA
• John E Barsa, M.D., PA

• Surgery Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.