JON D WIESE MD FACS PA (NPI# 1902078512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902078512 |
| Entity Type | Organization |
| Organization Name | JON D WIESE MD FACS PA |
| Practice Address |
521 W State Road 434 Suite 305 Longwood FL 32750-4984 |
| Practice Telephone | 4073321995 |
| Practice Fax Number | 4073321404 |
| Mailing Telephone | 4073321995 |
| Mailing Fax Number | 4073321404 |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2008-04-03 |
| Authorized Official Name | DR. JON D. WIESE (PRESIDENT) |
| Authorized Official Telephone | 4073321995 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | ME54060 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
521 W STATE ROAD 434 SUITE 305 |
| City | LONGWOOD |
| State | FL |
| Zip Code | 32750-4984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891738407 | Elizabeth P Heil | Internal Medicine | 521 W State Road 434, Suite 302, Longwood, FL 32750-4984 | 2006-06-13 |
| 1568727584 | Saulius J Jankauskas Md | Plastic Surgery | 521 W State Road 434, Suite 106, Longwood, FL 32750-4984 | 2012-07-05 |
| 1104059666 | Joan M Farmer | Nurse Practitioner | 521 W State Road 434, Suite 101, Longwood, FL 32750-4984 | 2009-09-01 |
| 1073764403 | Bertrand Bezanchong Teh Fonji | Surgery | 521 W State Road 434, Suite 301, Longwood, FL 32750-4984 | 2008-10-03 |
| 1932388196 | Robert W. Burns M.d., Facs Pl | Surgery | 521 W State Road 434, Suite 306, Longwood, FL 32750-4984 | 2007-10-24 |
| 1942495445 | Longwood Foot & Ankle Physician Pa | Podiatrist | 521 W State Road 434, Suite 300, Longwood, FL 32750-4984 | 2007-09-09 |
| 1225251739 | Elizabeth Heil Md Inc | Internal Medicine | 521 W State Road 434, Suite 302, Longwood, FL 32750-4984 | 2007-04-11 |
| 1952474561 | Jon D Wiese | Surgery | 521 W State Road 434, Suite 301, Longwood, FL 32750-5166 | 2006-11-15 |
| 1316962574 | Saulius J Jankauskas | Plastic Surgery | 521 W State Road 434, Longwood, FL 32750-4984 | 2006-07-12 |
| 1992730550 | Progressive Pediatrics of Orlando Pa | Pediatrics | 521 W State Road 434, Suite 101, Longwood, FL 32750 | 2006-07-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902420920 | Prn Speech Pathologists | Speech-Language Pathologist | 1704 N. Ronald Reagan Blvd, Longwood, FL 32750 | 2020-06-05 |
| 1831743368 | Shamar Anthony Marston | Nurse Anesthetist, Certified Registered | 555 W Fl - 434, Longwood, FL 32750 | 2019-08-01 |
| 1538639125 | Omega Healthcare Solutions, LLC | Case Management | 160 W. Evergreen Avenue Suite 290, Longwood, FL 32750 | 2018-11-27 |
| 1013416080 | Samantha Jane Roberts | Specialist/Technologist, Other | 163 W Bay Ave, Longwood, FL 32750 | 2018-02-06 |
| 1508375874 | Cassandra Thompson-bailey | Nurse Practitioner | 600 N Us Hwy 17 92, Suite 124, Longwood, FL 32750 | 2017-09-29 |
| 1740799535 | Cornerstone Longwood Leasing, LLC | Assisted Living Facility | 480 E. Church Ave., Longwood, FL 32750 | 2017-09-25 |
| 1659890523 | Melissa Shoshana Vigerito | Marriage & Family Therapist | 978 Douglas Ave. Suite 100, Altamonte Springs, FL 32750 | 2017-09-12 |
| 1619498185 | Calm Relief, LLC | Massage Therapist | 1855 W State Road 434, Ste 253, Longwood, FL 32750 | 2017-07-05 |
| 1497145148 | Caitlin Rhea Hilligas | Counselor | 300 N Ronald Reagan Blvd Ste 302, Longwood, FL 32750 | 2015-02-03 |
| 1316344054 | James David Rawlins Jr. | Dentist | 1250 W.s.r 434 Ste. 1008, Longwood, FL 32750 | 2014-11-24 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326369455 | Jessica M Gielow | Surgery | 521 W State Road 434 Ste 301, Longwood, FL 32750-5166 | 2010-06-11 |
| 1740510668 | Terry L Ballard | Surgery | 107 Rockingham Ct, Longwood, FL 32779-4635 | 2009-12-29 |
| 1285771444 | Kristin L Wulff | Surgery | 295 W Pine Ave, Longwood, FL 32750-4138 | 2007-01-30 |
| 1669874442 | Womens Health Surgical Solutions LLC | Surgery | 225 W State Road 434, Suite 202, Longwood, FL 32750-4980 | 2014-09-23 |
| 1073764403 | Bertrand Bezanchong Teh Fonji | Surgery | 521 W State Road 434, Suite 301, Longwood, FL 32750-4984 | 2008-10-03 |
| 1932388196 | Robert W. Burns M.d., Facs Pl | Surgery | 521 W State Road 434, Suite 306, Longwood, FL 32750-4984 | 2007-10-24 |
| 1952474561 | Jon D Wiese | Surgery | 521 W State Road 434, Suite 301, Longwood, FL 32750-5166 | 2006-11-15 |
| 1932278306 | Robert William Burns | Surgery | 521 West State Road 434, Suite 306, Longwood, FL 32750-5166 | 2006-11-07 |
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|---|---|---|---|---|
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| 1932713476 | Gabriel Nicolas Chapman | Surgery | 12301 Trout Cir, Spring Hill, FL 34609-4962 | 2020-09-02 |
| 1396356960 | After Hours Surgical Care LLC | Surgery | 11766 Foxbriar Lake Trl, Boynton Beach, FL 33473-7830 | 2020-08-16 |
| 1588288203 | Samuel Joseph | Surgery | 22730 Sw 55th Ave, Boca Raton, FL 33433-6258 | 2020-05-29 |
| 1720601768 | Ked Medical, P.a. | Surgery | 3001 N Rocky Point Dr E Ste 100, Tampa, FL 33607-5860 | 2020-05-26 |
| 1952922270 | Glenn Edmund Bryan Jr. | Surgery | 4255 N Us Highway 1, Melbourne, FL 32935-4822 | 2020-04-27 |
| 1821618729 | Herbert Paul Lerner | Surgery | 10815 Royal Devon Way, Lake Worth, FL 33449-8650 | 2020-04-21 |
| 1003441981 | Comprehensive Care Partners | Surgery | 3101 University Blvd S Ste 100, Jacksonville, FL 32216-2750 | 2020-03-11 |
| 1831749977 | Imed Surgical of Miami, Pa | Surgery | 175 Sw 7th St Ste 1710, Miami, FL 33130-2957 | 2019-09-19 |
| 1174170914 | Vip Surgeries | Surgery | 1301 E Broward Blvd Ste 220, Fort Lauderdale, FL 33301-2111 | 2019-08-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.