Individual
MIRNA ANTONIETA WAIDELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7100 W CAMINO REAL, SUITE 200, BOCA RATON, FL 33433-5510
(561) 391-6552
(561) 391-6285
Mailing address
7100 W CAMINO REAL, SUITE 200, BOCA RATON, FL 33433-5510
(561) 391-6552
(561) 391-6285
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9101003
FL
Other
Enumeration date
07/21/2006
Last updated
12/20/2016
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