Individual
ANDREW K. WEITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3161 HARBOR BLVD, UNIT D, PT CHARLOTTE, FL 33952-6754
(941) 625-1550
(941) 255-0794
Mailing address
2234 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
OS9827
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1193518
WELLCARE
FL
01
—
258608
AVMED
FL
05
—
279029700
—
FL
01
—
5127
OPER. ENGIN. PROV. #
FL
01
—
54327
BCBS FL PROVIDER #
FL
01
—
5839421
AETNA PROVIDER #
FL
01
—
OS9827
METCARE PROVIDER #
FL
01
—
P01791741
CLEAR HEALTH ALLIANCE
FL
01
—
QMP000005122907
MOLINA
FL
Enumeration date
07/19/2006
Last updated
04/21/2017
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