Widdler Deshommes, MD
General Practice in Mount Dora, Florida
1376172015- Practice location
- 4601 N Highway 19A, Mount Dora, FL 32757-2039
- Phone
- 352-290-8718
- Fax
- —
- Last updated
- March 8, 2024
Widdler Deshommes is a General Practice based in Mount Dora, FL. Widdler Deshommes practices in Mount Dora, FL and has the professional credentials of MD. The NPI Number for Widdler Deshommes is 1376172015 and holds a License No. 023661 (PR). The current practice location address for Widdler Deshommes is 4601 N Highway 19A, Mount Dora, FL 32757-2039 and can be reached out via phone at 352-290-8718.
Provider Profile Details
- NPI Number
- 1376172015
- Provider Name
- Widdler Deshommes
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 4601 N Highway 19A, Mount Dora, FL 32757-2039
- Phone Number
- 352-290-8718
- Primary Taxonomy
- General Practice · 208D00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- April 4, 2020
- Last Update Date
- March 8, 2024
- Certification Date
- March 8, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 4601 N Highway 19A
Mount Dora, FL 32757-2039 - City
- Mount Dora
- State
- Florida
- Zip
- 32757-2039
- Phone Number
- 352-290-8718
Provider Business Mailing Address Details
- Address
- 550 Rouzer St
Apopka, FL 32712-3650 - City
- Apopka
- State
- FL
- Zip
- 32712-3650
- Phone Number
- 407-575-0943
License Information
- License Number (1)
- 023661
- License State (1)
- PR
- Taxonomy (1)
- General Practice · 208D00000X
- License Number (2)
- 000229-P.A
- License State (2)
- PR
- Taxonomy (2)
- Physician Assistant · 363A00000X
- License Number (3)
- 8363
- License State (3)
- AZ
- Taxonomy (3)
- Physician Assistant · 363A00000X
- License Number (4)
- TPPA363
- License State (4)
- FL
- Taxonomy (4)
- Physician Assistant · 363A00000X
- License Number (5)
- ACN1610
- License State (5)
- FL
- Taxonomy (5)
- General Practice · 208D00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other General Practice providers near Mount Dora, FL
View all General Practice providers in Mount Dora →Frequently Asked Questions
What is the NPI number of Widdler Deshommes, MD?
The NPI number of Widdler Deshommes, MD is 1376172015. It was assigned on April 4, 2020 and is currently active in the NPPES registry.
What is the specialty of Widdler Deshommes, MD?
Widdler Deshommes, MD is registered under the primary taxonomy General Practice (code 208D00000X), licensed in PR under license number 023661.
Where does Widdler Deshommes, MD practice?
The practice location is 4601 N Highway 19A, Mount Dora, FL 32757-2039. The office can be reached at 352-290-8718 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1376172015 directly on the NPPES registry website.