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Individual

KELSEY JUNE DIEMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
23450 VIA COCONUT PT, ESTERO, FL 34135-1877
(239) 343-9696
(239) 343-4198
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9696
(239) 343-4198

Taxonomy

Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
OS20212
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119160500
FL
Enumeration date
03/22/2019
Last updated
11/06/2025
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