Individual
DR. FREDERICK THOMAS WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1859 SW NEWLAND WAY, LAKE CITY, FL 32025-6966
(386) 758-0003
(386) 755-7940
Mailing address
1859 SW NEWLAND WAY, LAKE CITY, FL 32025-6966
(386) 758-0003
(386) 755-7940
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
ME24619
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055611400
—
FL
Enumeration date
05/31/2005
Last updated
10/19/2011
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