Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME0068491 | FL |
NPI | 1053342386 |
---|---|
Provider Name | Mark P Weintraub |
First Address | Fort Myers, FL 33907-1412 |
Second Address | Bradenton, FL 34205-8626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 26/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
012776600 | (05) | FL |
09134 | UNIVERSAL (01) | FL |
1193517 | WELLCARE (01) | FL |
27451 | BCBS FL (01) | FL |
353795 | AVMED (01) | FL |
5103435 | AETNA (01) | FL |
G12770 | (02) | FL |
P01040599 | RAILROAD MCR (01) | FL |
P102261 | FREEDOM HEALTH (01) | FL |
P939415 | OPTIMUM (01) | FL |