WAYNE DIEDRICK

HOLLYWOOD, FL
NPI1083626386
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AS0400X Physician Assistant Surgical
(Licence: FL  PA3021)
Enumeration Date2006-08-13
Last Update Date2007-07-08
Business Address
WAYNE DIEDRICK PA
3501 JOHNSON ST
HOLLYWOOD, FL 33021-5421
Phone number: 954-987-2020
Mailing Address
WAYNE DIEDRICK PA
PO BOX 862233
ORLANDO, FL 32886-2233
Phone number: 954-276-5575