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Organization
INTERNAL MEDICINE & PEDIATRICS WELLNESS CENTER
Active
Organization
INTERNAL MEDICINE & PEDIATRICS WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARLENE A. WILSON MD (OWNER/PHYSICIAN)
(352) 795-2459
Entity
Organization
Contact information
Practice address
6038 W. NORDLING LOOP, CRYSTAL RIVER, FL 34429
(352) 795-2459
(352) 795-4322
Mailing address
PO BOX 2012, LECANTO, FL 34460
(352) 795-2459
(352) 795-4322
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME93743
FL
208000000X
Pediatrics Physician
ME93743
FL
Other
Enumeration date
03/30/2007
Last updated
06/05/2014
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