Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | G47964 | CA |
Y | 207RX0202X | Medical Oncology | ME99194 | FL |
NPI | 1053348706 |
---|---|
Provider Name | Dr. Jeffrey Weber |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33612-9416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 07/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
278581100 | (05) | FL |
90621 | BCBS (01) | FL |