| Waden E Emery Iii M D P A | |
|
5340 N Federal Hwy Suite 205 Lighthouse Point FL 33064-7058 | |
| (954) 771-8300 | |
| (954) 771-4002 |
| Full Name | Waden E Emery Iii M D P A |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5340 N Federal Hwy, Lighthouse Point, Florida |
| Authorized Official Name and Position | Waden Everett Emery (PRESIDENT) |
| Authorized Official Contact | 9547718300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waden E Emery Iii M D P A 5340 N Federal Hwy Suite 205 Lighthouse Point FL 33064-7058 Ph: (954) 771-8300 | Waden E Emery Iii M D P A 5340 N Federal Hwy Suite 205 Lighthouse Point FL 33064-7058 Ph: (954) 771-8300 |
| NPI Number | 1740447176 |
|---|---|
| Provider Enumeration Date | 05/22/2008 |
| Last Update Date | 06/19/2008 |
| Medicare PECOS PAC ID | 1456420553 |
|---|---|
| Medicare Enrollment ID | O20080515000206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740447176 | NPI | - | NPPES |
| 049128400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME45215 (Florida) | Primary |
| Provider Name | Waden E Emery |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831154319 PECOS PAC ID: 1658440755 Enrollment ID: I20080515000188 |
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