Individual
BRUCE EDWARD WIITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1002 S OLD DIXIE HWY, SUITE 104, JUPITER, FL 33458-7202
(561) 747-5885
(561) 743-5456
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0014196
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1022104
CAREPLUS
FL
01
—
1261707
WELLCARE-MEDICARE
FL
01
—
210784
AVMED
FL
01
—
2180836
CIGNA
FL
01
—
P01649432
RR MEDICARE
FL
01
—
P971351
OPTIMUM
FL
01
—
P996325
FREEDOM
FL
01
—
QMP000004225143
MOLINA
FL
Enumeration date
06/10/2006
Last updated
07/10/2017
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