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General NPI Number Information
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NPI Number | 1013325448
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Entity Type | Individual
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Provider Name | GEORGE ESTOL WADSWORTH NP-C
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Gender | Male
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Dates
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Enumeration Date | 07/29/2014
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 275 18TH ST STE 102
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City | VERO BEACH
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State | FL
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Zip | 32960-0824
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Country | US
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Telephone | 772-559-9998
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Fax | 772-299-3653
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Provider Business Mailing Address
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Address Line | 275 18TH ST STE 102
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City | VERO BEACH
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State | FL
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Zip | 32960-0824
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Country | US
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Telephone | 772-559-9998
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Fax | 772-299-3653
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9263504
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License Number State | FL
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