Weise, Edmund R

Weise, Edmund R is an individual health care provider with primary practice located at 274 3Rd Ave S , Jacksonville Beach FL 32250-6727. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Weise, Edmund R can be contacted via phone (904) 249-3373.

Contact Information

Primary practice address
274 3Rd Ave S Jacksonville Beach FL 32250-6727
Phone: (904) 249-3373
Fax: (904) 249-3371
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME8046 Florida

Profile Details

NPI number 1851349039
LBN Legal business name Weise, Edmund R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Aug 31st, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851349039 NPPES
Florida MEDICAID 264895400

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