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Individual

DR. EDWARD L WIENER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
21110 BISCAYNE BLVD SUITE 400, AVENTURA, FL 33180
(305) 933-8622
(305) 682-8430
Mailing address
21110 BISCAYNE BLVD SUITE 400, AVENTURA, FL 33180
(305) 933-8622
(305) 682-8430

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OS3845
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
064580000
FL
01
82412
BLUECROSS BLUESHIELD
FL
Enumeration date
03/09/2006
Last updated
09/12/2011
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