Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PYOOO3331 | FL |
Y | 103TC0700X | Clinical Psychologist | PYOOO3331 | FL |
NPI | 1013068584 |
---|---|
Provider Name | Dr. Eric Lawrence Diamond |
First Address | Gainesville, FL 32606-7432 |
Second Address | Gainesville, FL 32606-7432 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
59-3255945 | (02) | FL |