Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | ME140744 | FL |
NPI | 1215370903 |
---|---|
Provider Name | Raquel Ann Weston |
First Address | Tallahassee, FL 32308-4638 |
Second Address | Tallahassee, FL 32308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2013 |
Last Update Date | 26/08/2019 |