Wilson, Latresia Ann

Wilson, Latresia Ann is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-3003. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Wilson, Latresia Ann can be contacted via phone (352) 265-5911.

Contact Information

Primary practice address
1600 Sw Archer Rd Gainesville FL 32610-3003
Phone: (352) 265-5911
Fax: (352) 265-5606
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ME0087826 Florida

Profile Details

NPI number 1649241613
LBN Legal business name Wilson, Latresia Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Oct 21st, 2009 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649241613 NPPES
Florida MEDICAID 267598600

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