Provider Demographics
NPI:1275096596
Name:NOWAK, DIANA AGNIESZKA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:AGNIESZKA
Last Name:NOWAK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3795 TAMIAMI TRL
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-7900
Mailing Address - Country:US
Mailing Address - Phone:941-505-8882
Mailing Address - Fax:
Practice Address - Street 1:3795 TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-7900
Practice Address - Country:US
Practice Address - Phone:941-505-8882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0022047183500000X
FLPS68095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist