Individual
DR. DIANE M MAGEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
201 MAGNOLIA AVE SW, WINTER HAVEN, FL 33880-2943
(866) 234-8534
Mailing address
47 5TH ST NW, WINTER HAVEN, FL 33881-4672
(863) 229-7970
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS11324
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012762700
—
FL
Enumeration date
04/04/2008
Last updated
07/29/2020
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