Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 304283 | LA |
N | 207RP1001X | Pulmonary Disease | 304283 | LA |
N | 207RP1001X | Pulmonary Disease | C52127 | CA |
Y | 207RP1001X | Pulmonary Disease | ME130463 | FL |
NPI | 1629104807 |
---|---|
Provider Name | David Weill |
First Address | Rosemary Beach, FL 32461-1004 |
Second Address | Tampa, FL 33612-4742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2007 |
Last Update Date | 07/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C521270 | (05) | CA |
020028900 | (05) | FL |
F96815 | (02) | CA |
QSBYQ | BLUE CROSS BLUE SHIELD (01) | FL |