Healthcare Provider Details

I. General information

NPI: 1184707283
Provider Name (Legal Business Name): ARLENE WEINSHELBAUM MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 09/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6820 NW 11TH PL
GAINESVILLE FL
32605-4217
US

IV. Provider business mailing address

6820 NW 11TH PL SUITE 3
GAINESVILLE FL
32605-4217
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-0115
  • Fax: 352-331-2044
Mailing address:
  • Phone: 352-331-0115
  • Fax: 352-331-2044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME 17557
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME 17558
License Number StateFL

VIII. Authorized Official

Name: ARLENE M WEINSHELBAUM
Title or Position: PRESIDENT
Credential: MD
Phone: 352-331-0115