Individual
DR. DWAYNE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3978 W HILLSBOROUGH AVE UNIT 21B, TAMPA, FL 33614-5628
(813) 906-1412
(813) 413-1971
Mailing address
6100 BLUE LAGOON DR STE 365, MIAMI, FL 33126-7010
(786) 322-7333
(786) 322-7329
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME121189
FL
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
ME121189
FL
Other
Enumeration date
07/12/2010
Last updated
01/09/2020
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