Individual
DR. DIANA L EDGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP RADIOLOGY DEPT., JACKSONVILLE, FL 32209-6511
(904) 244-4224
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME46121
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0414409-00
—
FL
05
—
417257752A
—
GA
Enumeration date
12/13/2005
Last updated
06/03/2009
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