Provider Demographics
NPI:1295077584
Name:GEORGE, WESLEY V (MD)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:V
Last Name:GEORGE
Suffix:
Gender:
Credentials:MD
Other - Prefix:MR
Other - First Name:WESLEY
Other - Middle Name:
Other - Last Name:BENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:222 S PENINSULA DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-4422
Mailing Address - Country:US
Mailing Address - Phone:386-310-2160
Mailing Address - Fax:386-310-2106
Practice Address - Street 1:298 S YONGE ST
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-6264
Practice Address - Country:US
Practice Address - Phone:386-274-7897
Practice Address - Fax:386-274-7801
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME131703207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program