Healthcare Provider Details

I. General information

NPI: 1508806902
Provider Name (Legal Business Name): JAMES WEIXLER
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 W NEW HAVEN AVE
MELBOURNE FL
32904-3916
US

IV. Provider business mailing address

5000 CHESHIRE LN N
PLYMOUTH MN
55446-3706
US

V. Phone/Fax

Practice location:
  • Phone: 321-725-4948
  • Fax: 321-725-0831
Mailing address:
  • Phone: 888-333-9152
  • Fax: 763-268-4240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS3104
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: