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General NPI Number Information
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NPI Number | 1437808128
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Entity Type | Organization
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Legal Business Name | WIMMER ORTHOPEDICS LLC
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 3384 WOODS EDGE CIR STE 104
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-1367
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Country | US
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Telephone | 239-829-4300
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Fax | 844-750-0691
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Provider Business Mailing Address
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Address Line | 3384 WOODS EDGE CIR STE 104
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-1367
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Country | US
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Telephone | 239-829-4300
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Fax | 844-750-0691
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Authorized Official
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Title or Position | OWNER
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Name | DEREK WIMMER
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Credential | MD
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Telephone | 239-829-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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