Provider Demographics
NPI:1174693477
Name:ALBRIGHT, DIANE (LM)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:ALBRIGHT
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4622 DONOVAN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-2710
Mailing Address - Country:US
Mailing Address - Phone:407-257-6514
Mailing Address - Fax:
Practice Address - Street 1:370 CENTER POINTE CIR
Practice Address - Street 2:BLD 401 SUITE 1537
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-3459
Practice Address - Country:US
Practice Address - Phone:407-265-9787
Practice Address - Fax:407-265-9788
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW113175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay