Provider Demographics
NPI:1306283924
Name:DIOGENE, ERIKA (DO)
Entity type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:
Last Name:DIOGENE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 BABCOCK ST NE STE 302
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-4648
Mailing Address - Country:US
Mailing Address - Phone:321-285-7212
Mailing Address - Fax:321-250-2038
Practice Address - Street 1:5200 BABCOCK ST NE STE 302
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4648
Practice Address - Country:US
Practice Address - Phone:321-285-7212
Practice Address - Fax:321-250-2038
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13874208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics