Organization
FLORIDA INSTITUTE OF DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WAUDO WANGIA MD (PHYSICIAN/OWNER)
(407) 395-3770
Entity
Organization
Contact information
Practice address
201 N PARK AVE STE 204, APOPKA, FL 32703-4147
(407) 395-3770
(407) 395-3779
Mailing address
201 N PARK AVE STE 204, APOPKA, FL 32703-4147
(407) 395-3770
(407) 395-3779
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103439400
—
FL
Enumeration date
06/02/2021
Last updated
06/02/2021
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