Wertheim, Michael Stanley

Wertheim, Michael Stanley is an individual health care provider with primary practice located at 1871 Se Tiffany Ave Suite 100, Port St Lucie FL 34952-7585. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Wertheim, Michael Stanley can be contacted via phone (772) 335-5666.

Contact Information

Primary practice address
1871 Se Tiffany Ave Suite 100 Port St Lucie FL 34952-7585
Phone: (772) 335-5666
Fax: (772) 335-4826
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 0046325 Florida

Profile Details

NPI number 1982643474
LBN Legal business name Wertheim, Michael Stanley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Jun 16th, 2010 - about 16 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 1982643474 NPPES
Florida Other 0046325 FLORIDA MEDICAL LICENSE
Florida MEDICAID 047329400 FLORIDA MEDICAL LICENSE
Florida Other 830003200 FLORIDA MEDICAL LICENSE
Florida Other 56158 FLORIDA MEDICAL LICENSE

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