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General NPI Number Information
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NPI Number | 1700866035
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Entity Type | Individual
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Provider Name | LEWIS WASSERMAN MD
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Gender | Male
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 844 N THORNTON AVE
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City | ORLANDO
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State | FL
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Zip | 32803-4003
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Country | US
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Telephone | 407-398-6470
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Fax |
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Provider Business Mailing Address
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Address Line | 1306 CENTURY OAK DR
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City | OCOEE
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State | FL
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Zip | 34761-4026
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Country | US
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Telephone | 407-247-9894
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME53446
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License Number State | FL
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