Individual
KARL WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001565
NY
363AS0400X
Surgical Physician Assistant
Primary
PA9103198
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100741100
—
FL
01
—
3BSL8
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/08/2007
Last updated
10/30/2018
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