Individual
BRIAN ADAM WIEDERHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9910 SANDALFOOT BLVD STE 1, BOCA RATON, FL 33428-6692
(561) 883-3030
(561) 852-7611
Mailing address
9910 SANDALFOOT BLVD STE 1, BOCA RATON, FL 33428-6692
(561) 883-3030
(561) 852-7611
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9117384
FL
Other
Enumeration date
02/24/2023
Last updated
07/31/2023
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