Provider Demographics
NPI:1396730537
Name:WANG, JANICE M (MD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:M
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 915193
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-5193
Mailing Address - Country:US
Mailing Address - Phone:941-342-8200
Mailing Address - Fax:941-342-8201
Practice Address - Street 1:5560 BEE RIDGE RD
Practice Address - Street 2:SUITE D3
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1508
Practice Address - Country:US
Practice Address - Phone:941-342-8200
Practice Address - Fax:941-342-8201
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME58835207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC86997Medicare UPIN
FL11496ZMedicare ID - Type Unspecified