Individual
GEORGE W WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12 CROSSWAY CT E, PALM COAST, FL 32137-8903
(386) 864-7378
(386) 864-7378
Mailing address
12 CROSSWAY CT E, PALM COAST, FL 32137-8903
(386) 864-7378
(386) 864-7378
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC001255
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078813900
—
FL
Enumeration date
07/10/2006
Last updated
12/23/2008
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