Individual
MRS. DIANA HERTEL WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
455 PINELLAS ST STE 320, CLEARWATER, FL 33756-3369
(727) 446-2273
(727) 441-4966
Mailing address
455 PINELLAS ST STE 320, CLEARWATER, FL 33756-3369
(727) 446-2273
(727) 447-5972
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9102544
FL
363AS0400X
Surgical Physician Assistant
Primary
PA102544
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105528400
—
FL
Enumeration date
09/26/2005
Last updated
04/13/2023
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