Jonathan Wideroff, M.D.

Surgery Physician · Boca Raton, FL

Individual Active NPI

NPI number 1215925367

Practice location

1601 Clint Moore Rd Ste 145
Boca Raton, FL 33487-5720
Phone
(561) 288-2537
Fax
(561) 939-5460

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NPI record

NPI
1215925367
Entity type
Individual (Type 1)
Enumeration date
October 12, 2005
Last updated
September 24, 2020
Certified
September 24, 2020
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Surgery Physician Primary 208600000X ME35997 FL
Specialist 174400000X ME35997 FL

Mailing address

1601 Clint Moore Rd
Suite 145
Boca Raton, FL 33487-2768
Phone
(561) 939-0455
Fax
(561) 939-5460

About Dr. Wideroff

Jonathan Wideroff, M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Surgery Physician (code 208600000X). The practice location is 1601 Clint Moore Rd Ste 145, Boca Raton, FL 33487-5720. The NPI number 1215925367 was assigned on October 12, 2005 and the record was last updated on September 24, 2020.

Dr. Wideroff lists 2 licenses in the registry: #ME35997 (FL) for Surgery Physician; #ME35997 (FL) for Specialist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jonathan Wideroff, M.D.?

The NPI number is 1215925367.

What is the phone number of Dr. Wideroff?

The phone number listed for the practice location is (561) 288-2537.

Where is Dr. Wideroff located?

1601 Clint Moore Rd Ste 145, Boca Raton, FL 33487-5720.

What is the taxonomy code for Dr. Wideroff?

The primary taxonomy code is 208600000X – Surgery Physician; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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