Wimpelberg, Phillip Alex

Wimpelberg, Phillip Alex is an individual health care provider with primary practice located at 2720 Us Highway 1 S Ste B, St Augustine FL 32086-6301. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Wimpelberg, Phillip Alex can be contacted via phone (904) 827-0078.

Contact Information

Primary practice address
2720 Us Highway 1 S Ste B St Augustine FL 32086-6301
Phone: (904) 827-0078
Fax: (904) 827-0140
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9101929 Florida

Profile Details

NPI number 1871686352
LBN Legal business name Wimpelberg, Phillip Alex
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Jan 31st, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871686352 NPPES
Florida MEDICAID 291914100
Florida Other P00295658

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