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

Individual provider Surgical Physician Assistant · NPI 1083626386

Wayne Diedrick, PA is a Surgical Physician Assistant in Hollywood, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3501 Johnson St
Hollywood, FL 33021-5421
Phone: (954) 987-2020
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA3021 (FL)

Record details

NPI number1083626386
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedAugust 13, 2006
Last updated in NPPESJuly 8, 2007
Mailing addressPo Box 862233, Orlando, FL 32886-2233

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