DR. JUDITH E. WALL (NPI# 1972612745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972612745 |
| Entity Type | Individual |
| Full Name | DR. JUDITH E. WALL |
| Credential | MD |
| Practice Address |
1717 S Orange Ave Suite 100 Orlando FL 32806-2944 |
| Mailing Address |
Po Box 191 Provider Enrollment Dept Rockland DE 19732-0191 |
| Practice Telephone | 4076507000 |
| Practice Fax Number | 4076507124 |
| Mailing Telephone | 3026516212 |
| Mailing Fax Number | 3026514945 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2011-11-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
ME54564 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 6728804 | 05 | |
| NC | 7612489 | 05 | |
| MA | 3205461 | 05 | |
| NY | 01602271 | 05 | |
| FL | 373323800 | 05 | |
| RI | JW35718 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649837493 | Judith Wall | Psychologist | 64 Dungarrie Rd, Catonsville, MD 21228-3401 | 2019-05-28 |
| 1619029683 | Judith V Wall | Social Worker | 759 Sw Federal Hwy, #203, Stuart, FL 34994-2914 | 2007-01-18 |
| Street Address |
1717 S ORANGE AVE SUITE 100 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32806-2944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124027867 | Wadih S. Macksoud | Orthopaedic Surgery | 1717 S Orange Ave, #103, Orlando, FL 32806-2944 | 2005-07-15 |
| 1700379385 | Children's Eyewear Center, Inc | Technician/Technologist | 1717 S Orange Ave, Orlando, FL 32806 | 2018-06-08 |
| 1255838462 | Mark Vincent Mandese | Technician/Technologist | 1717 S Orange Ave, Orlando, FL 32806-2944 | 2018-04-12 |
| 1700325693 | Daniela Galvez Moreno | Behavioral Analyst | 1717 S Orange Ave, Orlando, FL 32806 | 2017-02-13 |
| 1194108928 | Krisann Draves | Nurse Practitioner | 1717 S Orange Ave, Suite 100, Orlando, FL 32806 | 2015-06-29 |
| 1437567989 | Jessica S Pierce | Psychologist | 1717 S Orange Ave, Suite 100, Orlando, FL 32806-2944 | 2014-07-29 |
| 1609287481 | Maggie Hodges | Physical Medicine & Rehabilitation | 1717 S Orange Ave, Suite 101, Orlando, FL 32806-2944 | 2014-05-14 |
| 1619394384 | Aimee Molineaux | Dietitian, Registered | 1717 S Orange Ave, Suite #100, Orlando, FL 32806-2944 | 2014-03-19 |
| 1508298407 | Sandra Karen Conrad | Dietitian, Registered | 1717 S Orange Ave, Suite 100, Orlando, FL 32806-2946 | 2013-08-01 |
| 1841635463 | Michelle P Tellado | General Practice | 1717 S Orange Ave, Orlando, FL 32806-2944 | 2013-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710585674 | Erika Williams | Pharmacist | 2715 South Orlando Ave, Orlando, FL 32806 | 2020-10-13 |
| 1013545664 | Johanna Yadira Cook | Registered Nurse | Orlando Health Orlando Regional Medical Center, 52 W. Underwood St, Orlando, FL 32806 | 2020-03-30 |
| 1396372306 | Warren Andrew Williams | Student in an Organized Health Care Education/Training Program | 1222 S. Orange Ave., 5th Fl, Mp# 43, Orlando, FL 32806 | 2020-03-27 |
| 1225665433 | Astrid Helen Casin | Student in an Organized Health Care Education/Training Program | 1222 S. Orange Avenue, 5th Fl., Mp#43, Orland, FL 32806 | 2020-03-26 |
| 1508404211 | Hidden Potential Florida LLC | Assistant Behavior Analyst | 2857 South Bumby Avenue, Orlando, FL 32806 | 2019-12-12 |
| 1720639883 | Cynthia Lee Kling | Clinical Nurse Specialist | Arnold Palmer Hospital, 92 W. Miller St., Orlando, FL 32806 | 2019-09-20 |
| 1033769930 | Darleen Ann Williams | Clinical Nurse Specialist | 52 W. Underwood, Orlando, FL 32806 | 2019-09-13 |
| 1508412644 | Trischaday Kimberley Demetrius | Nurse Practitioner | Orlando Epilepsy Center, 226 W Michigan Street, Orlando, FL 32806 | 2019-08-14 |
| 1962964809 | Ajc Software Inc | Prosthetic/Orthotic Supplier | 1405 South Orange Avenue Suite 308, Orlando, FL 32806 | 2019-04-01 |
| 1598232852 | Sodo Smiles Dentistry, Pa | Dentist | 3123 S. Orange Ave., Suite 107, Orlando, FL 32806 | 2018-10-25 |
| Find all providers in zip 32806 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518010164 | David Richard Shook | Pediatrics | 2501 N Orange Ave Ste 589, Orlando, FL 32804-4647 | 2007-01-18 |
| 1740748797 | Annabeth Walters Huff | Pediatrics | 92 W Miller Street, Orlando, FL 32806 | 2019-03-08 |
| 1710457684 | Kristen Beth Gibbs | Pediatrics | 13535 Nemours Pkwy, Orlando, FL 32827-7402 | 2018-12-04 |
| 1285038687 | Farranaz Alvarez Nunez | Pediatrics | 92 W Miller St, Orlando, FL 32806-2032 | 2014-10-14 |
| 1992048649 | Claudia P Zapata | Pediatrics | 92 W Miller St, Orlando, FL 32806-2032 | 2013-04-01 |
| 1497010813 | Avery Colleen Wright | Pediatrics | 92 W Miller St, Orlando, FL 32806-2032 | 2012-07-11 |
| 1609019207 | Heather Brittany Allewelt | Pediatrics | 2501 N Orange Ave Ste 589, Orlando, FL 32804-4647 | 2009-04-13 |
| 1497957591 | Robert M Sutphin | Pediatrics | 92 W Miller St, Orlando, FL 32806-2032 | 2007-06-01 |
| 1134279177 | Ramamoorthy Nagasubramanian | Pediatrics | 1717 S Orange Ave, Suite 100, Orlando, FL 32806-2944 | 2007-01-11 |
| 1275560831 | Paul R. Gordon | Pediatrics | 1717 S Orange Ave Ste 100, Nemours Childrens Clinic, Orlando, Orlando, FL 32806-2946 | 2006-06-27 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.