Jon D Wiese MD Facs PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME54060 Issued in FL

Legal business name

JON D WIESE MD FACS PA

Practice address

521 W State Road 434
Suite 305
Longwood, FL 32750-4984

Phone

(407) 332-1995

Fax

(407) 332-1404

NPI assigned

Mar 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jon D. Wiese, M.D.

Title

President

Phone

(407) 332-1995

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1902078512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 W STATE ROAD 434",
            "address_2": "SUITE 305",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504984",
            "telephone_number": "407-332-1995",
            "fax_number": "407-332-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W STATE ROAD 434",
            "address_2": "SUITE 305",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504984",
            "telephone_number": "407-332-1995",
            "fax_number": "407-332-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON D WIESE MD FACS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "WIESE",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-332-1995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME54060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaina Johnson
• Brookcalleda Deeperlina Johnson
• Dale S Johnson, O.D.
• Melody Marie Johnson, PA-C
• Nancy C Johnston, MS, CCC-SLP
• Emily Jones
• Maylynn Jones, MSW
• Shawntrece Jones
• Tina Marie Jones, ARNP
• Abigail Joseph

• Surgery Physician in Longwood, FL
• Providers in Longwood, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.