Individual
CARMEN JOSEFA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
820 W SUGARLAND HWY, CLEWISTON, FL 33440
(941) 792-2020
Mailing address
PO BOX 162264, ALTAMONTE SPRINGS, FL 32716-2264
(941) 792-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
044609
GA
207W00000X
Ophthalmology Physician
Primary
ME140321
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000791249B
—
GA
Enumeration date
07/21/2005
Last updated
08/05/2024
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