Individual
WALTER A CONLAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 W GORE ST, ORLANDO, FL 32806-1113
(321) 841-5469
(321) 841-7470
Mailing address
55 W GORE ST, ORLANDO, FL 32806-1113
(321) 841-5469
(321) 841-7470
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
ME70963
FL
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
ME70963
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250013030
RAILROAD MEDICARE
FL
05
—
251971200
—
FL
Enumeration date
08/09/2006
Last updated
10/08/2019
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