Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME45451 | FL |
NPI | 1003807116 |
---|---|
Provider Name | Dr. Dana James Weinkle |
First Address | Bradenton, FL 34209-9675 |
Second Address | Bradenton, FL 34209-5642 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 03/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
180043832 | RAILROAD MEDICARE (01) | |
D58970 | (02) |