Healthcare Provider Details

I. General information

NPI: 1184402885
Provider Name (Legal Business Name): WIEHTANIA F LAWAL CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2023
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N EDINBURGH DR STE 200
WINTER PARK FL
32792-4125
US

IV. Provider business mailing address

PO BOX 748817
ATLANTA GA
30374-8817
US

V. Phone/Fax

Practice location:
  • Phone: 407-645-5565
  • Fax: 888-720-2569
Mailing address:
  • Phone: 813-286-0033
  • Fax: 813-282-1806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11028505
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: