Individual
WESLEY ROLAND INNOCENT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
2685 EXECUTIVE PARK DR, WESTON, FL 33331-3651
(954) 515-0892
(954) 349-0896
Mailing address
2031 NW 6TH CT, POMPANO BEACH, FL 33069-2406
(561) 289-5774
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
PTA30120
FL
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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