Individual
DIA MARIE O'CONNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 SW ARCHER RD, GAINESVILLE, FL 32608-1134
(352) 273-6575
Mailing address
4190 NW 50TH DR APT 7309, GAINESVILLE, FL 32606-0004
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100964100
—
FL
Enumeration date
08/19/2018
Last updated
11/14/2018
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