Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Raina Diedrick, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1073895132

Raina Diedrick, PHYSICIANASSISTANT is a Physician Assistant in Fort Lauderdale, Florida. Works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2011
Specialties on file
2
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Practice location Address checks out

1995 E Oakland Park Blvd Ste 310
Fort Lauderdale, FL 33306-1138
Phone: (954) 791-6146
Fax: (954) 337-2733
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 17546 Montessa Ter, Jacksonville, FL 32226-1122 — (561) 385-4029

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9107904 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 000000000 (FL)

Record details

NPI number1073895132
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedSeptember 15, 2011
Last updated in NPPESJune 10, 2020
Certification dateJune 10, 2020
Mailing address1995 E Oakland Park Blvd, Ste 310, Fort Lauderdale, FL 33306-1138

Other providers in Fort Lauderdale