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General NPI Number Information
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NPI Number | 1609967512
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Entity Type | Individual
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Provider Name | MICHAEL H WILENSKY M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 04/07/2009
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Provider Practice Location Address
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Address Line | 17971 BISCAYNE BLVD SUITE 108
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City | AVENTURA
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State | FL
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Zip | 33160-2578
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Country | US
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Telephone | 305-948-8825
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Fax | 305-466-7045
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Provider Business Mailing Address
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Address Line | 17971 BISCAYNE BLVD SUITE 108
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City | AVENTURA
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State | FL
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Zip | 33160-2578
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Country | US
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Telephone | 305-948-8825
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Fax | 305-466-7045
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME-0033139
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License Number State | FL
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