Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YP0228X | Pediatric Otolaryngology | 42792 | CO |
Y | 207YP0228X | Pediatric Otolaryngology | ME121693 | FL |
NPI | 1023009966 |
---|---|
Provider Name | Dr. Andreas H Werle |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33908-5768 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
013955900 | (05) | FL |
102300966 | (05) | WY |
1023009966 | (05) | NE |
14426242 | (05) | CO |
IA779Z | (02) | FL |