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Individual

ADAM WANNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1611 NW 12TH AVE, BOX 016960 M851, MIAMI, FL 33136-1005
(305) 585-1111
Mailing address
1500 NW 12TH AVE, JMT-EAST 1007, MIAMI, FL 33136-1028
(305) 243-4664

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME24616
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3718514-00
FL
Enumeration date
08/03/2006
Last updated
01/31/2014
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