Provider Demographics
NPI:1598077703
Name:HENDRICKS, WESLEY AARON (DO)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:AARON
Last Name:HENDRICKS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5741 BEE RIDGE RD STE 560
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-5080
Mailing Address - Country:US
Mailing Address - Phone:941-277-8919
Mailing Address - Fax:941-497-3328
Practice Address - Street 1:5741 BEE RIDGE RD STE 560
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5080
Practice Address - Country:US
Practice Address - Phone:941-277-8919
Practice Address - Fax:941-497-3328
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17916208600000X
OH34.010524208600000X
ZZOS17916208600000X
OH390200000X
MS23844208600000X
FLOS17916208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program