Provider Demographics
NPI:1881747715
Name:WALFORD, NEBBIE ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:NEBBIE
Middle Name:ELIZABETH
Last Name:WALFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:601 5TH ST S
Mailing Address - Street 2:SUITE 306
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4804
Mailing Address - Country:US
Mailing Address - Phone:727-767-4170
Mailing Address - Fax:727-767-4346
Practice Address - Street 1:601 5TH ST S
Practice Address - Street 2:SUITE 306
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4804
Practice Address - Country:US
Practice Address - Phone:727-767-4170
Practice Address - Fax:727-767-4346
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1066152086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDO0900ZOtherMEDICARE
FL001989600Medicaid
FL1488JOtherBCBS
FL3895403OtherCIGNA
FL188174771501OtherPRESTIGE HEALTH CHOICE