Provider Demographics
NPI:1073516290
Name:WARE, ANTHONY WESTON (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:WESTON
Last Name:WARE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8005 BAY ST
Mailing Address - Street 2:STE 2
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3244
Mailing Address - Country:US
Mailing Address - Phone:772-589-0331
Mailing Address - Fax:772-770-5817
Practice Address - Street 1:1160 BROADBAND DR
Practice Address - Street 2:SUITE F1
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2623
Practice Address - Country:US
Practice Address - Phone:321-255-9310
Practice Address - Fax:321-752-5218
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2014-07-22
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Provider Licenses
StateLicense IDTaxonomies
FLME76509207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG93815Medicare UPIN