Individual
THOMAS E WISWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2718 N ORANGE AVE, SUITE B, ORLANDO, FL 32804-7611
(407) 894-1465
(407) 894-9176
Mailing address
2718 N ORANGE AVE, SUITE B, ORLANDO, FL 32804-7611
(407) 894-1465
(407) 894-9176
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
ME90867
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48165
BCBS
FL
Enumeration date
06/16/2006
Last updated
07/08/2007
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