Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | ME123822 | FL |
NPI | 1194046144 |
---|---|
Provider Name | David A Weinstein |
First Address | Orlando, FL 32817-1492 |
Second Address | Orlando, FL 32827-7665 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2010 |
Last Update Date | 24/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015369100 | (05) | FL |