Organization
PETER G WERNICKI M D P A
Active
Other names
Pro Sports
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA P MULLIKIN (ADMIN ASSISTANT)
(772) 978-7808
Entity
Organization
Contact information
Practice address
787 37TH ST STE E200, VERO BEACH, FL 32960-7306
(772) 978-7808
(772) 978-9320
Mailing address
787 37TH ST STE E200, VERO BEACH, FL 32960-7306
(772) 978-7808
(772) 978-9320
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266151900
—
FL
01
—
45408
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
07/03/2006
Last updated
08/10/2022
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