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Organization
PINNACLE HEALTH GROUP PA
Active
Organization
PINNACLE HEALTH GROUP PA
Active
Other names
Pinnacle Health Group Plant City
Organization subpart
No
Provider details
NPI number
Authorized official
SAM DIASTI MD (PRESIDENT / MEDICAL DIRECTOR)
(813) 874-5500
Entity
Organization
Contact information
Practice address
1601 W REYNOLDS ST STE 201, PLANT CITY, FL 33563-4747
(813) 874-5500
(813) 874-5505
Mailing address
PO BOX 18344, TAMPA, FL 33679-8344
(813) 874-5500
(813) 874-5505
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27330300
—
FL
01
—
ME71925
MEDICAL LICENSE
FL
Enumeration date
03/23/2022
Last updated
03/31/2022
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