Individual
DR. ADAM DIASTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2307 S DALE MABRY HWY, SUITE C, TAMPA, FL 33629-6322
(813) 254-6838
Mailing address
4010 W BOY SCOUT BLVD, SUITE 1100-CREDENTIALING, TAMPA, FL 33607-5727
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401102418
VA
1223G0001X
General Practice Dentistry
DN011634
GA
1223G0001X
General Practice Dentistry
Primary
DN12490
FL
1223G0001X
General Practice Dentistry
DS0000007478
TN
Other
Enumeration date
08/30/2006
Last updated
06/29/2011
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