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Individual

MARK P WEINTRAUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 3RD AVE W, SUITE 210, BRADENTON, FL 34205-8626
(941) 792-0340
(941) 794-2251
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME0068491
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
012776600
FL
01
09134
UNIVERSAL
FL
01
1193517
WELLCARE
FL
01
27451
BCBS FL
FL
01
353795
AVMED
FL
01
5103435
AETNA
FL
01
P01040599
RAILROAD MCR
FL
01
P102261
FREEDOM HEALTH
FL
01
P939415
OPTIMUM
FL
Enumeration date
07/05/2006
Last updated
04/26/2016
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