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Organization
WEECARE FOR KIDS PA
Active
Organization
WEECARE FOR KIDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER SUE THOLE MD (OWNER)
(813) 236-9000
Entity
Organization
Contact information
Practice address
11948 BALM RIVERVIEW RD, RIVERVIEW, FL 33569-6601
(813) 236-9000
(813) 236-9002
Mailing address
11948 BALM RIVERVIEW RD, RIVERVIEW, FL 33569-6601
(813) 236-9000
(813) 236-9002
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME82918
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005NB
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/02/2014
Last updated
08/27/2014
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