Individual provider · Type 1 NPI

Mirna Antonieta Waidele, PA

Medical Physician Assistant · Boca Raton, FL

NPI number 1013938778 Active

Practice location

7100 W Camino Real, Suite 200
Boca Raton, FL 33433-5510

Call (561) 391-6552 Map

Fax (561) 391-6285

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA9101003 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1013938778

Mirna Antonieta Waidele, PA's National Provider Identifier is 1013938778, issued on Jul 21, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Boca Raton, FL. The record was last updated on Dec 20, 2016.