Provider Demographics
NPI:1588685374
Name:DRUMMOND, WILLA H (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLA
Middle Name:H
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WILLA
Other - Middle Name:HENDRICKS
Other - Last Name:DRUMMOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-392-4195
Practice Address - Fax:352-392-4533
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME343482080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL037026600Medicaid
D57803Medicare UPIN
FL68156ZMedicare PIN
FL037026600Medicaid