Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | ME71839 | FL |
NPI | 1104989789 |
---|---|
Provider Name | Dr. Ann T Weber |
First Address | Gainesville, FL 32606-7495 |
Second Address | Gainesville, FL 32606-5603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 13/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
264011200 | (05) | FL |
43970 | BCBS FL (01) | FL |
H05042 | (02) | FL |