Individual
DR. MARK EDWARD DIEBEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11945 SAN JOSE BLVD, JACKSONVILLE, FL 32223-1613
(904) 398-0033
(904) 398-6774
Mailing address
11945 SAN JOSE BLVD, STE 300, JACKSONVILLE, FL 32223-1627
(904) 396-1725
(904) 396-4893
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME132260
FL
2086S0127X
Trauma Surgery Physician
Primary
69439-20
WI
Other
Enumeration date
07/25/2012
Last updated
10/12/2019
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