Provider Demographics
NPI:1003807116
Name:WEINKLE, DANA JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:JAMES
Last Name:WEINKLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 LANDINGS CIR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-9675
Mailing Address - Country:US
Mailing Address - Phone:941-792-2509
Mailing Address - Fax:
Practice Address - Street 1:5601 21ST AVE W
Practice Address - Street 2:SUITE A
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5642
Practice Address - Country:US
Practice Address - Phone:941-794-2020
Practice Address - Fax:941-792-3464
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME45451207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
180043832OtherRAILROAD MEDICARE
D58970Medicare UPIN
FLK0672AMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
FLK0672Medicare ID - Type UnspecifiedMEDICARE GRUOP NUMBER
FL79896ZMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
FL79896YMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER