Provider Demographics
NPI:1053190611
Name:PHYSICIANS WEIGHT LOSS OF FLORIDA
Entity type:Organization
Organization Name:PHYSICIANS WEIGHT LOSS OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN'S ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:V
Authorized Official - Last Name:ALANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:239-695-8446
Mailing Address - Street 1:3515 DEL PRADO BLVD S
Mailing Address - Street 2:
Mailing Address - City:SUITE 107
Mailing Address - State:FL
Mailing Address - Zip Code:33914
Mailing Address - Country:US
Mailing Address - Phone:239-695-8446
Mailing Address - Fax:
Practice Address - Street 1:3515 DEL PRADO BLVD S STE 107
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7289
Practice Address - Country:US
Practice Address - Phone:239-695-8446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty