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Individual

DR. DIANE L GOLDWATER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D., PH.D.

Contact information

Practice address
830 A1A NORTH SUITE 13, #105, PONTE VEDRA BEACH, FL 32082
(310) 535-1778
Mailing address
PO BOX 2647, PONTE VEDRA BEACH, FL 32004-2647
(310) 535-1778

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
H4354
TX
207P00000X
Emergency Medicine Physician
ME63438
FL
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
A045037
CA

Other

Enumeration date
11/08/2006
Last updated
09/11/2025
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