Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | ME0066191 | FL |
N | 207KA0200X | Allergist | ME0066191 | FL |
NPI | 1336218650 |
---|---|
Provider Name | Dr. Michael Barry Wein |
First Address | Vero Beach, FL 32960-2427 |
Second Address | Vero Beach, FL 32960-2427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 03/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
375839700 | (05) | FL |
F84169 | (02) | FL |