MEDICARE: CHRISTINE WILSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747A0650X	Attendant Care Provider		FL

General Provider Information

NPI Number	:	1255271839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE WILSON

Provider Business Mailing Address
First Line	:	6726 LOQUAT LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-4949
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6726 LOQUAT LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-4949
Country	:	US
Telephone Number	:	407-421-7435
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2026
Last Update Date	:	03/31/2026

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