Individual
DR. BARRY J. WECKESSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1370 E VENICE AVE, SUITE 102, VENICE, FL 34285-9082
(941) 412-0026
(941) 412-0027
Mailing address
1370 E VENICE AVE, SUITE 102, VENICE, FL 34285-9082
(941) 412-0026
(941) 412-0027
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME15557
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14622
BCBS
FL
01
—
202641604
TAX ID
FL
05
—
370246400
—
FL
Enumeration date
09/06/2005
Last updated
07/25/2012
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