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Individual

MICHAEL A DIAMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
709 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-1603
(386) 252-1632
(386) 257-5526
Mailing address
709 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-1603
(386) 252-1632
(386) 257-5526

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
ME0013576
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036454100
FL
01
64350
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
08/18/2005
Last updated
03/12/2013
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