Individual provider · Type 1 NPI

Wayne Diedrick, PA

Surgical Physician Assistant · Hollywood, FL

NPI number 1083626386 Active

Practice location

3501 Johnson St
Hollywood, FL 33021-5421

Call (954) 987-2020 Map

Mailing address

PO Box 862233
Orlando, FL 32886-2233

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA3021 (FL)

Surgical Physician Assistant: Definition to come...

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About NPI 1083626386

Wayne Diedrick, PA's National Provider Identifier is 1083626386, issued on Aug 13, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Hollywood, FL. The record was last updated on Jul 8, 2007.