Wilson, Latresia Ann
Wilson, Latresia Ann is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-3003. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Wilson, Latresia Ann can be contacted via phone (352) 265-5911.Contact Information
Primary practice address
1600 Sw Archer Rd
Gainesville FL 32610-3003
Phone: (352) 265-5911
Fax: (352) 265-5606
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | ME0087826 | Florida |
Profile Details
| NPI number | 1649241613 |
|---|---|
| LBN Legal business name | Wilson, Latresia Ann |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2006 |
| Last updated | Oct 21st, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649241613 | NPPES |
| Florida | MEDICAID | 267598600 |
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