Healthcare Provider Details

I. General information

NPI: 1659900959
Provider Name (Legal Business Name): CONNOR WAYMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 NW 9TH AVE STE 700
MIAMI FL
33136-1100
US

IV. Provider business mailing address

1801 NW 9TH AVE STE 700
MIAMI FL
33136-1100
US

V. Phone/Fax

Practice location:
  • Phone: 702-853-3561
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: