DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DIANA ICKES, PTA

Active

DIANA ICKES, PTA is a Specialist/Technologist, Surgical healthcare provider located in RIVERVIEW, Florida. NPI 1669923496 is currently active in the NPPES registry. Verify at CMS.

Specialist/Technologist, Surgical · RIVERVIEW, FL

Registration Details

NPI Number
1669923496
Provider Type
Individual
Gender
Female
NPI Issued
Oct 17, 2016 (9.856059212823 yrs)
Last Updated
Oct 17, 2016
License
PTA17336 (FL)

Practice Information

Address
11458 CAPTIVA KAY DR
RIVERVIEW, FL, 335692057
Browse FL providers · Browse ZIP 33569
Phone
9418128159
Primary Specialty
Specialist/Technologist, Surgical
246Z00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.