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Individual

KATE LAUREN WEED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1714 MAHAN CENTER BLVD, TALLAHASSEE, FL 32308-5427
(850) 877-4134
(850) 402-9130
Mailing address
1714 MAHAN CENTER BLVD, TALLAHASSEE, FL 32308-5427
(850) 877-4134
(850) 402-9130

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9104795
FL
363AM0700X
Medical Physician Assistant
Primary
PA9104795
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BP475Z
MEDICARE
FL
01
Y06TB
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
09/29/2008
Last updated
12/09/2014
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