Provider Demographics
NPI:1184707283
Name:ARLENE WEINSHELBAUM MD PA
Entity type:Organization
Organization Name:ARLENE WEINSHELBAUM MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEINSHELBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-331-0115
Mailing Address - Street 1:6820 NW 11TH PL
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4217
Mailing Address - Country:US
Mailing Address - Phone:352-331-0115
Mailing Address - Fax:352-331-2044
Practice Address - Street 1:6820 NW 11TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4217
Practice Address - Country:US
Practice Address - Phone:352-331-0115
Practice Address - Fax:352-331-2044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 17558208600000X
FLME 175572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94999Medicare ID - Type Unspecified