Provider Demographics
NPI:1487937173
Name:WAITE, WILLIAM CARLYLE (DO)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CARLYLE
Last Name:WAITE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1414 KUHL AVE # MP31
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2008
Mailing Address - Country:US
Mailing Address - Phone:407-841-5133
Mailing Address - Fax:407-237-6313
Practice Address - Street 1:1222 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1215
Practice Address - Country:US
Practice Address - Phone:407-650-1300
Practice Address - Fax:407-650-1307
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2022-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL18719207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9106184OtherMEDICAL LICENSE
FL004222200Medicaid
FL004222200Medicaid