Provider Demographics
NPI:1467667261
Name:WESS, RENE L
Entity Type:Individual
Prefix:MRS
First Name:RENE
Middle Name:L
Last Name:WESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 WEDGEWOOD DR NE
Mailing Address - Street 2:APT 207
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-6203
Mailing Address - Country:US
Mailing Address - Phone:321-729-9401
Mailing Address - Fax:
Practice Address - Street 1:3300 WEDGEWOOD DR NE
Practice Address - Street 2:APT 207
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-6203
Practice Address - Country:US
Practice Address - Phone:321-729-9401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician