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Organization

JOHN A DIETRICK M D P L

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN A DIETRICK III MD (OWNER)
(813) 971-8883
Entity
Organization

Contact information

Practice address
13801 BRUCE B DOWNS BLVD, SUITE 104, TAMPA, FL 33613-3946
(813) 971-8883
(813) 971-2491
Mailing address
13801 BRUCE B DOWNS BLVD, SUITE 104, TAMPA, FL 33613-3946
(813) 971-8883
(813) 971-2491

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME88224
FL

Other

Enumeration date
01/02/2008
Last updated
01/02/2008
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