Individual
DR. LEWIS WASSERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
844 N THORNTON AVE, ORLANDO, FL 32803-4003
(407) 398-6470
Mailing address
1306 CENTURY OAK DR, OCOEE, FL 34761-4026
(407) 247-9894
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME53446
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063328300
—
FL
01
—
07509
BLUE CROSS/BLUE SHIELD
FL
01
—
202855
AMERIGROUP
FL
01
—
222125
STAYWELL
FL
01
—
4008151
CIGNA
FL
Enumeration date
01/20/2006
Last updated
09/07/2016
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