Provider Demographics
NPI:1093714891
Name:WAND, PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:WAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 N UNIVERSITY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6184
Mailing Address - Country:US
Mailing Address - Phone:954-344-9722
Mailing Address - Fax:954-741-2126
Practice Address - Street 1:2232 N UNIVERSITY DR
Practice Address - Street 2:SUITE A
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6184
Practice Address - Country:US
Practice Address - Phone:954-344-9722
Practice Address - Fax:954-741-2126
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00411172084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94063Medicare ID - Type Unspecified
FLD78847Medicare UPIN