Individual
MRS. DIANE ROSE BRONKEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ROT
Contact information
Practice address
625 6TH AVE S STE 450, ST PETERSBURG, FL 33701-4629
(727) 898-2663
Mailing address
625 6TH AVE S STE 450, ST PETERSBURG, FL 33701-4629
(727) 898-2663
Taxonomy
Speciality
Code
Description
License number
State
246ZX2200X
Orthopedic Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/15/2020
Last updated
01/19/2022
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