Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 1646 | CA |
Y | 213ES0103X | Foot & Ankle Surgery | PO3364 | FL |
NPI | 1013068089 |
---|---|
Provider Name | Dr. Jamie Elise Weaver |
First Address | Naples, FL 34108-8913 |
Second Address | Naples, FL 34108-8913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 09/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
65082 | BLUE CROSS BLUE SHIELD FLORIDA (01) | FL |
PO3364 | FL PODIATRIC LICENSE (01) | FL |