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NPI Code Detail

MEDICARE: DR. WADIH S. MACKSOUD M.D.

MEDICARE: DR. WADIH S. MACKSOUD M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianME0056028FL
2207XS0106XOrthopaedic Hand Surgery PhysicianME0056028FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
109393OTHERFLBC/BS
2200030018OTHERFLRAILROAD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124027867
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WADIH S. MACKSOUD M.D.
Provider Business Mailing Address
First Line : 1285 ORANGE AVE
Second Line :
City : WINTER PARK
State : FL
Zip : 32789-4949
Country : US
Telephone Number : 407-647-2287
Fax Number : 407-643-1300
Provider Business Practice Location Address
First Line : 1717 S ORANGE AVE
Second Line : #103
City : ORLANDO
State : FL
Zip : 32806-2944
Country : US
Telephone Number : 407-236-0404
Fax Number : 407-236-0402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 05/15/2015

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