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Individual

CONSTANCE WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
200 SW 62ND BLVD, SUITE C, GAINESVILLE, FL 32607-6030
(352) 265-9465
(352) 265-9466
Mailing address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-9465
(352) 265-9466

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9108835
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015624800
FL
Enumeration date
08/05/2015
Last updated
07/03/2019
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