Active NPI
Henry E Wiley III, M.D.
- Dermatopathology Physician
- Tampa, FL
National Provider Identifier
1023033719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatopathology Physician
- License
- ME0025943
- Practice address
- 1425 S Howard Ave
Tampa, FL 33606-3126 - Phone
- (813) 253-2635
- Fax
- (813) 254-7142
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatopathology Physician | 207ND0900X | ME0025943 | FL | Primary |
Addresses
Primary practice location
1425 S Howard Ave
Tampa, FL 33606-3126
Mailing address
916 S Golf View St
Tampa, FL 33629-5222
Phone (813) 251-3906
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0025943 | FL | MD | Dermatopathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336003200000",
"number": "1023033719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 S GOLF VIEW ST",
"city": "TAMPA",
"state": "FL",
"postal_code": "336295222",
"telephone_number": "813-251-3906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 S HOWARD AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336063126",
"telephone_number": "813-253-2635",
"fax_number": "813-254-7142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "HENRY",
"middle_name": "E",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2012-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "207ND0900X",
"taxonomy_group": "",
"desc": "Dermatology, Dermatopathology",
"state": "FL",
"license": "ME0025943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.