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Individual

KURT L WIESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
2900 N MILITARY TRL STE 243, BOCA RATON, FL 33431-6362
(561) 496-1095
(561) 948-4473
Mailing address
2900 N MILITARY TRL STE 243, BOCA RATON, FL 33431-6362
(561) 496-1095
(561) 948-4473

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME0061675
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME0061675
MEDICAL LICENSE NUMBER
FL
Enumeration date
10/23/2006
Last updated
11/07/2022
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