Provider Demographics
NPI:1528481314
Name:DIMINO, JOSEPH M (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:DIMINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 RIVERSIDE DR
Mailing Address - Street 2:101A
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-5098
Mailing Address - Country:US
Mailing Address - Phone:941-729-7192
Mailing Address - Fax:
Practice Address - Street 1:1050 RIVERSIDE DR
Practice Address - Street 2:101A
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-5098
Practice Address - Country:US
Practice Address - Phone:941-729-7192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 20603261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care