Healthcare Provider Details

I. General information

NPI: 1144540873
Provider Name (Legal Business Name): JAMEE M WALTERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 6TH AVE S
ST PETERSBURG FL
33701-4634
US

IV. Provider business mailing address

83 COLUMBIA ST
ORLANDO FL
32806-1106
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-4243
  • Fax: 727-767-8612
Mailing address:
  • Phone: 321-843-3220
  • Fax: 321-843-3210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2013-01299
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME121777
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME121777
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: