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Individual

JOHN W WAIDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4712
(904) 308-7372
(904) 308-6909
Mailing address
2627 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4712
(904) 308-7372
(904) 308-6909

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME 0062495
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2595028-00
FL
Enumeration date
01/30/2006
Last updated
06/12/2009
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