Walter a Conlan III MD PA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

ME70963 Issued in FL

Legal business name

WALTER A CONLAN III MD PA

Doing business as

Florida Wound Care Doctors

Practice address

1415 Gene St
Winter Park, FL 32789-4840

Phone

(407) 339-4499

Fax

(407) 339-4903

NPI assigned

Oct 12, 2007

Last updated

Oct 8, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Walter A Conlan III, M.D.

Title

Owner/Ceo

Phone

(407) 339-4499

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Florida Wound Care Doctors Doing business as

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melodie Blakely, DPT, CWS

  • Physical Therapist
  • Orlando, FL
  • NPI 1093215998
  NPD (past)
• Kristin L Wulff, MD

  • Surgery Physician
  • Daytona Beach, FL
  • NPI 1285771444
  NPD (past)
• Michael Joseph Cascio, MD

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1275541799
  NPD (past)
• Sandra Milena Hayes, MD

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • San Diego, CA
  • NPI 1740431444
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1558559765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 GENE ST",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894840",
            "telephone_number": "407-339-4499",
            "fax_number": "407-339-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 GENE ST",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894840",
            "telephone_number": "407-339-4499",
            "fax_number": "407-339-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER A CONLAN III MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "CONLAN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "407-339-4499",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME70963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277683900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DE4519",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Wound Care Doctors",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• La Tanya D Walker
• Macy Walker
• Danielle Charisse Wallace, M.D.
• Matthew Wallace, PSY.D.
• David Regis Walsh, LMHC
• Linda H. Walters, D.M.D.
• Brenda Walton-Scott
• Peyton Waltz
• Tianxing Wang, A.P
• Wang's Acupuncture Inc

• Physical Medicine & Rehabilitation Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.