Provider Demographics
NPI:1124771043
Name:DR. WENDY WAI AND ASSOCIATES
Entity type:Organization
Organization Name:DR. WENDY WAI AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SZE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WAI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:904-315-9012
Mailing Address - Street 1:2119 BLACK LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4659
Mailing Address - Country:US
Mailing Address - Phone:407-463-5039
Mailing Address - Fax:
Practice Address - Street 1:3343 DANIELS RD
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-7009
Practice Address - Country:US
Practice Address - Phone:407-656-2319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty