Doctor Name: | MS. DONNA WEIDEMA WEIDEMA |
NPI Number: | 1841417623 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | 625742 |
Business Practice Address: | 3000 Ne 151st St North Miami, FL - 331813605 |
Business Phone Number: | 3059195620 |
Business Fax Number: | 3059194003 |
Mailing Address: | 630 Layne Blvd, #202 HALLANDALE BEACH |
State: | FL |
Postal Code: | 330096584 |
Phone Number: | 3054907581 |
Fax Number: | |
NPI Enumeration Date: | 04/20/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 625742 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |