Doctor Name: | MRS. ELIZABETH V WEISE |
NPI Number: | 1215278916 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | AL9646 |
Business Practice Address: | 2360 Madrid Ave Se Palm Bay, FL - 329096427 |
Business Phone Number: | 3219568141 |
Business Fax Number: | 3217681220 |
Mailing Address: | 2360 Madrid Ave Se, PALM BAY |
State: | FL |
Postal Code: | 329096427 |
Phone Number: | 3219568141 |
Fax Number: | 3217681220 |
NPI Enumeration Date: | 03/06/2013 |
NPI Last Update Date: | 03/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | AL9646 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |