Eugene E Wenthe JR.
Family Doctor
1223 Gateway Dr Ste 1e
Melbourne
, Florida 32901-2607
Eugene E Wenthe JR.
Family Doctor
1223 Gateway Dr Ste 1e
Melbourne
, Florida 32901-2607
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About
Features
Specialties
- Family Doctor
Languages spoken
- English
Location
First Address
- Eugene E Wenthe JR.
- 3300 S Fiske Blvd
- Rockledge, FL
- Zip : 32955-4306
- Phone :
Second Address
- Eugene E Wenthe JR.
- 1223 Gateway Dr Ste 1e
- Melbourne, FL
- Zip : 32901-2607
- Fax : (321) 409-6823
- Phone : (321) 725-4505
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Is Eugene E Wenthe JR. a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Q00000X | Family Doctor | 036061047 | IL |
| Y | 207Q00000X | Family Doctor | ME117071 | FL |
National Provider Identifier
| NPI | 1003826918 |
|---|---|
| Provider Name | Eugene E Wenthe JR. |
| First Address | Rockledge, FL 32955-4306 |
| Second Address | Melbourne, FL 32901-2607 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/08/2006 |
| Last Update Date | 31/10/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 020057300 | BLACK LUNG (01) | IL |
| 036061047 | (05) | IL |
| 036061047 | IL STATE LICENSE (01) | IL |
| 054913 | HEALTH ALLIANCE (01) | IL |
| 080098256 | RR MEDICARE PIN (01) | IL |
| 08421024 | BC/BS (01) | IL |
| 101343 | HEALTHLINK (01) | IL |
| 133586700 | ACS-OWCP (01) | IL |
| 14D0949277 | CLIA (01) | IL |
| 170774 | PERSONAL CARE (01) | IL |
| 6394P | CATERPILLAR (01) | IL |
| C39981 | (02) | IL |
| CD7143 | RR MEDICARE GROUP (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.