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General NPI Number Information
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NPI Number | 1639448525
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Entity Type | Organization
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Legal Business Name | NORMA L WAITE MD - MEDICAL GROUP LLC
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 6000 TURKEY LAKE RD SUITE NUMBER 112
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City | ORLANDO
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State | FL
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Zip | 32819-4200
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Country | US
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Telephone | 407-363-9499
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Fax | 407-363-9622
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Provider Business Mailing Address
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Address Line | 6000 TURKEY LAKE RD SUITE NUMBER 112
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City | ORLANDO
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State | FL
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Zip | 32819-4200
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Country | US
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Telephone | 407-363-9499
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Fax | 407-363-9622
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Authorized Official
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Title or Position | OWNER
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Name | DR. NORMA L WAITE
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Credential | M.D
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Telephone | 407-363-9499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0037750
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License Number State | FL
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