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NPI Code Detail

MEDICARE: CANDACE WONSEY

MEDICARE:   CANDACE  WONSEY
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
11744P3200XProsthetics Case ManagementCL1208534FL

General Provider Information

NPI Number : 1376981688
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDACE WONSEY
Provider Business Mailing Address
First Line : 11140 RUNNING PINE DR
Second Line :
City : RIVERVIEW
State : FL
Zip : 33569-2212
Country : US
Telephone Number : 407-758-8298
Fax Number :
Provider Business Practice Location Address
First Line : 2327 WINDING CV
Second Line :
City : OVIEDO
State : FL
Zip : 32765-6376
Country : US
Telephone Number : 407-758-8298
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2013
Last Update Date : 11/11/2018

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Directions to “ CANDACE WONSEY ” Practice Location

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