Provider Demographics
NPI:1497126387
Name:WALWEMA, FRANCIS WAMAMERA
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:WAMAMERA
Last Name:WALWEMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15955 SW 96TH ST
Mailing Address - Street 2:SUITE #406A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1271
Mailing Address - Country:US
Mailing Address - Phone:786-467-3420
Mailing Address - Fax:786-533-9680
Practice Address - Street 1:15955 SW 96TH ST
Practice Address - Street 2:SUITE #406A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1271
Practice Address - Country:US
Practice Address - Phone:786-467-3420
Practice Address - Fax:786-533-9680
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-17
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9264201363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health