Organization Active NPI

Robert L R Wesly M D PH D P a

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Gainesville, FL
National Provider Identifier
1043407851
Registry record updated Dec 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
ME44335 Issued in FL
Legal business name
ROBERT L R WESLY M D PH D P A
Practice address
2251 NW 41St St
Suite E
Gainesville, FL 32606-7498
Phone
(352) 377-6010
Fax
(352) 371-0039
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert L Wesly, MD-PHD
Title
President/Owner
Phone
(352) 377-6010

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X ME44335 FL
Surgical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086X0206X ME44335 FL
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X ME44335 FL Primary

Addresses

Primary practice location

2251 NW 41St St
Suite E
Gainesville, FL 32606-7498

Mailing address

2251 NW 41St St
Suite E
Gainesville, FL 32606-7498
Phone (352) 377-6010

Other identifiers 4

IdentifierTypeStateIssuer
060066125OtherFLTRI-CARE
206847OtherFLAVMED
01375OtherFLBC-BS
068801100MedicaidFL

National Provider Directory

National Provider Directory

Locations

2251 NW 41st St
Ste E
Gainesville, FL 32606
Phone (352) 377-6010

2630 NW 41st St
Ste C3
Gainesville, FL 32606

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230681600000",
    "number": "1043407851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 NW 41ST ST",
            "address_2": "SUITE E",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067498",
            "telephone_number": "352-377-6010",
            "fax_number": "352-371-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 NW 41ST ST",
            "address_2": "SUITE E",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067498",
            "telephone_number": "352-377-6010",
            "fax_number": "352-371-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT L R WESLY M D PH D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2008-12-31",
        "status": "A",
        "authorized_official_last_name": "WESLY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "352-377-6010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD-PHD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME44335",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": "FL",
            "license": "ME44335",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME44335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI-CARE",
            "identifier": "060066125",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "206847",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC-BS",
            "identifier": "01375",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068801100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.