Provider Demographics
NPI:1689893018
Name:WIENER, VIKKI ANGERT (DO)
Entity Type:Individual
Prefix:DR
First Name:VIKKI
Middle Name:ANGERT
Last Name:WIENER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 COLLIER BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114
Mailing Address - Country:US
Mailing Address - Phone:239-354-4316
Mailing Address - Fax:239-354-4329
Practice Address - Street 1:8340 COLLIER BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-3625
Practice Address - Country:US
Practice Address - Phone:480-518-1776
Practice Address - Fax:239-325-9045
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3007207Q00000X
FLOS-8610207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine