Organization
FLORIDA INSTITUTE OF DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WAUDO WANGIA MD (MEDICAL DIRECTOR)
(352) 246-3254
Entity
Organization
Contact information
Practice address
1991 DANIELS RD, WINTER GARDEN, FL 34787
(407) 395-3770
(407) 395-3779
Mailing address
10747 EMERALD CHASE DR, ORLANDO, FL 32836-5876
(352) 246-3254
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
—
—
Other
Enumeration date
05/06/2019
Last updated
01/21/2020
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