WIDDLER DESHOMMES MD
Individual Provider (NPI-1)
Active
General Practice
Provider Information
- NPI Number
1376172015- Provider Type
- Individual Provider (NPI-1)
- Credentials
- MD
- Status
- Active
Contact & Location
- Address
- 4601 N HIGHWAY 19A, MOUNT DORA, FL, 327572039
- Phone
- (352) 290-8718
Specialties & Taxonomies
General Practice
License: PR #023661
Physician Assistant
License: PR #000229-P.A
Physician Assistant
License: AZ #8363
Physician Assistant
License: FL #TPPA363
General Practice
Primary License: FL #ACN1610