Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME0066713 | FL |
NPI | 1265591580 |
---|---|
Provider Name | Dr. Carlos E Wiegering |
First Address | Miami, FL 33133 |
Second Address | Key Biscayne, FL 33149-1543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 19/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F92593 | (02) | FL |