Provider Demographics
NPI:1215636444
Name:NOWAK, WARUNEE EMELIA (PA)
Entity type:Individual
Prefix:
First Name:WARUNEE
Middle Name:EMELIA
Last Name:NOWAK
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:151 SOUTHHALL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:866-400-3376
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:851 OUTER RD STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6652
Practice Address - Country:US
Practice Address - Phone:866-400-3376
Practice Address - Fax:407-982-4012
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2025-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9117220363AM0700X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical