Provider Demographics
NPI:1093179103
Name:JW PLASTIC SURGERY PLLC
Entity Type:Organization
Organization Name:JW PLASTIC SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-530-0250
Mailing Address - Street 1:1075 DUVAL ST
Mailing Address - Street 2:SUITE C19
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3115
Mailing Address - Country:US
Mailing Address - Phone:305-602-2500
Mailing Address - Fax:
Practice Address - Street 1:1075 DUVAL ST
Practice Address - Street 2:SUITE C19
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3115
Practice Address - Country:US
Practice Address - Phone:305-602-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117343174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty