Healthcare Provider Details

I. General information

NPI: 1154424539
Provider Name (Legal Business Name): SANGITA WALIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANGEETA WALIA MD

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 GEORGE BUSH BLVD
DELRAY BEACH FL
33483-5718
US

IV. Provider business mailing address

700 GEORGE BUSH BLVD
DELRAY BEACH FL
33483-5718
US

V. Phone/Fax

Practice location:
  • Phone: 561-276-5151
  • Fax: 561-276-3258
Mailing address:
  • Phone: 561-276-5151
  • Fax: 561-276-3258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME54321
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: