Provider Demographics
NPI:1730511361
Name:DIAMOND MEDICAL SERVICES, INC
Entity type:Organization
Organization Name:DIAMOND MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:239-691-0686
Mailing Address - Street 1:13180 N CLEVELAND AVE
Mailing Address - Street 2:#132
Mailing Address - City:N FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-6200
Mailing Address - Country:US
Mailing Address - Phone:239-997-2589
Mailing Address - Fax:855-427-1528
Practice Address - Street 1:13180 N CLEVELAND AVE
Practice Address - Street 2:#132
Practice Address - City:N FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-6200
Practice Address - Country:US
Practice Address - Phone:239-997-2589
Practice Address - Fax:855-427-1528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care