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Individual

CHESTER C WILMOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
407 S 11TH ST, LAKE WALES, FL 33853-4243
(863) 419-8366
Mailing address
1324 LAKELAND HILLS BLVD, ATTN: MANAGED CARE DEPT., LAKELAND, FL 33805-4543

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME97851
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001365900
FL
01
1073806
CAREPLUS
FL
01
2700158
UNITED
FL
01
309495
AVMED
01
6501728
CIGNA
FL
01
7053917
AETNA
FL
01
78191
BCBS
FL
01
P00753965
RAILROAD MEDICARE
FL
Enumeration date
07/21/2006
Last updated
08/25/2025
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