Individual
MR. LANCE DAVID WIENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA CCC SLP
Contact information
Practice address
2785 NE 183RD ST, AVENTURA, FL 33160-2171
(305) 932-8994
Mailing address
20281 E COUNTRY CLUB DR, APT 2504, AVENTURA, FL 33180-3010
(305) 937-4972
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SA510
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890177500
—
FL
Enumeration date
09/01/2006
Last updated
07/09/2007
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