Provider Demographics
NPI:1619323755
Name:WEINKLE, ALLISON (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:WEINKLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:WEINKLE
Other - Last Name:MITEVSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:907 3RD ST E
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4235
Mailing Address - Country:US
Mailing Address - Phone:941-504-3329
Mailing Address - Fax:
Practice Address - Street 1:3301 C ST STE 1300
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3370
Practice Address - Country:US
Practice Address - Phone:916-551-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-08
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA168686207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA168686OtherCA MEDICAL LICENSE