Individual
KADY NICOLE WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
596 COURTLAND BLVD, DELTONA, FL 32738-8902
(407) 249-1234
(407) 249-1755
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(954) 967-6400
(954) 337-5755
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9110125
FL
Other
Enumeration date
01/05/2017
Last updated
01/17/2024
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