Waite, George W
Waite, George W is an sole proprietor health care provider with primary practice located at 12 Crossway Ct E , Palm Coast FL 32137-8903. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Waite, George W can be contacted via phone (386) 864-7378.Contact Information
Primary practice address
12 Crossway Ct E
Palm Coast FL 32137-8903
Phone: (386) 864-7378
Fax: (386) 864-7378
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC001255 | Florida |
Profile Details
| NPI number | 1962436923 |
|---|---|
| LBN Legal business name | Waite, George W |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 10th, 2006 |
| Last updated | Dec 23rd, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962436923 | NPPES |
| Florida | MEDICAID | 078813900 |
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