Individual
NANCY WITHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1140 PRATT BLVD, LABELLE, FL 33935-4405
(863) 674-4041
Mailing address
PO BOX 70, LABELLE, FL 33975-0070
(863) 674-4041
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME63344
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372339900
—
FL
Enumeration date
08/10/2005
Last updated
10/01/2021
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