LYLE E WADSWORTH MD PA NPI 1205018207

NPI Information

  • NPI: 1205018207
  • Provider Name: LYLE E WADSWORTH MD PA
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • Address: 890 N BOUNDARY AVE STE 102
    DELAND, FL
    ZIP 32720
  • Phone: (386) 740-0224

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NPI Details

LYLE E WADSWORTH MD PA is an internal medicine in Deland, FL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. LYLE E WADSWORTH MD PA NPI is 1205018207. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

890 N BOUNDARY AVE STE 102
DELAND, FL
ZIP 32720-173
Phone: (386) 740-0224

The provider's authorized official is Lyle E. Wadsworth .
The authorized official title is President and has the following contact phone number (386) 740-0224.

The enumeration date for this NPI number is 11/30/2007 and was last updated on 3/6/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0300XInternal MedicineGeriatric MedicineME30902FLORIDANo
2207RH0002XInternal MedicineHospice and Palliative MedicineME30902FLORIDANo
3207R00000XInternal MedicineME30902FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D56770MEDICARE UPINFLORIDA
2000050266105OTHERFLORIDAUNITEDHEALTHCARE
35490138OTHERFLORIDAAETNA
464391OTHERFLORIDABLUE CROSS BLUE SHIELD
52198298007OTHERFLORIDACIGNA
6AH947MEDICARE PINFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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