Individual
JACOB VANDER WEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-6413
(407) 303-6414
Mailing address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-6413
(407) 303-6414
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301504289
MI
207P00000X
Emergency Medicine Physician
4351038388
MI
207P00000X
Emergency Medicine Physician
Primary
ME173594
FL
Other
Enumeration date
05/14/2018
Last updated
06/17/2025
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