Individual
DIANA K BLYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9655 NW 41ST ST, DORAL, FL 33178-2973
(305) 436-1563
(305) 436-1564
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(305) 436-1563
(305) 436-1564
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
C128729
CA
208000000X
Pediatrics Physician
Primary
ME104378
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110358200
—
FL
Enumeration date
06/23/2008
Last updated
12/08/2023
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