Provider Information for 1740511583
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
CAROL MARIE WATLER
Sex: Female
NPI: 1740511583
Last Updated: 2020-06-25
Certification Date: 2020-06-25
Certification Date: 2020-06-25
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1740511583 | ||||||||
| Enumeration Date | 2010-01-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 954 APOPKA, FL 32704-0954 United States Phone: 407-834-0942 | Fax:407-834-0945 | ||||||||
| Primary Practice Address | 238 N WESTMONTE DR STE 240 ALTAMONTE SPRINGS, FL 32714-3364 United States Phone: 407-834-0942 | Fax:407-834-0945 | ||||||||
| Secondary Practice Address(es) | 221 N HIGHWAY 27 UNIT A | ||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|