Individual
DIEDRE T CAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4270 LAKE IN THE WOODS DR, WEEKI WACHEE, FL 34607-2501
(352) 597-7249
(352) 597-9523
Mailing address
15215 CORTEZ BLVD, BROOKSVILLE, FL 34613-6072
(352) 799-0046
(352) 799-0115
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
ME 88175
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271034000
—
FL
01
—
37307
BCBS
FL
01
—
P01125564
RR MCR
FL
01
—
U1375S
MEDICARE TYPE - UNSPECIFIED
FL
Enumeration date
09/19/2005
Last updated
02/08/2013
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