Individual
ANNE K VAN WERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11715 ORPINGTON ST, SUITE A, ORLANDO, FL 32817-4600
(407) 380-9115
(407) 380-9189
Mailing address
P.O. BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME48566
FL
208D00000X
General Practice Physician
Primary
ME48566
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046470800
—
FL
Enumeration date
01/12/2006
Last updated
09/20/2012
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