Provider Demographics
NPI:1679518096
Name:WAITE, NORMA L (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:L
Last Name:WAITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6000 TURKEY LAKE RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-4200
Mailing Address - Country:US
Mailing Address - Phone:407-363-9499
Mailing Address - Fax:407-363-9622
Practice Address - Street 1:6000 TURKEY LAKE RD
Practice Address - Street 2:SUITE 112
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4200
Practice Address - Country:US
Practice Address - Phone:407-363-9499
Practice Address - Fax:407-363-9622
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0037750207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257451900Medicaid
FL257451900Medicaid
FL93970Medicare ID - Type Unspecified