Provider Demographics
NPI:1962428219
Name:WEEKES, ANNMARIE E (DO)
Entity type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:E
Last Name:WEEKES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:912 HAMILTON PLACE DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2667
Mailing Address - Country:US
Mailing Address - Phone:863-648-0377
Mailing Address - Fax:863-648-0377
Practice Address - Street 1:2200 OSPREY BLVD
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-3308
Practice Address - Country:US
Practice Address - Phone:863-519-1416
Practice Address - Fax:863-519-1427
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6136207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80521OtherBCBS
E96520Medicare UPIN
80521ZMedicare ID - Type Unspecified