Individual
DIANE WALDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1111 KANE CONCOURSE, SUITE 100, BAY HARBOR ISLANDS, FL 33154-2029
(305) 866-2177
(305) 866-5302
Mailing address
15051 S TAMIAMI TRL STE 203, FORT MYERS, FL 33908-5182
(239) 437-8810
(239) 313-2555
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME39412
FL
Other
Enumeration date
07/08/2006
Last updated
01/11/2018
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