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NPI Code Detail

MEDICARE: MR. ANDREW WEGMAN

MEDICARE: MR. ANDREW WEGMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystBA-0278AZ
2103K00000XBehavior Analyst1-16-24629TN

General Provider Information

NPI Number : 1154857316
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDREW WEGMAN
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number : 855-832-6727
Fax Number : 772-675-9100
Provider Business Practice Location Address
First Line : 424 CHURCH ST STE 2000
Second Line :
City : NASHVILLE
State : TN
Zip : 37219-3304
Country : US
Telephone Number : 855-832-6727
Fax Number : 772-675-9100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2017
Last Update Date : 12/22/2021

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