Dennis Darnell Wideman Ii, is a
Behavior Technician based in Port St Lucie, Florida. Dennis Darnell Wideman Ii is licensed to practice in * (Not Available) (license number ) and his current practice location is
1887 Se Port St Lucie Blvd, Port St Lucie, Florida. He can be reached at his office (for appointments etc.) via phone at
(772) 463-0444.
NPI number for Dennis Darnell Wideman Ii is 1255153094 and his current mailing address is 2547 Floridiane Dr, Melbourne, Florida. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1255153094.
Healthcare Provider's Profile
| Full Name | Dennis Darnell Wideman Ii |
|---|
| Gender | Male |
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| Speciality | Behavior Technician |
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| Location | 1887 Se Port St Lucie Blvd, Port St Lucie, Florida |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1255153094
- Provider Enumeration Date: 10/31/2024
- Last Update Date: 04/16/2025
Medical Identifiers
Medical identifiers for Dennis Darnell Wideman Ii such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1255153094 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dennis Darnell Wideman Ii is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dennis Darnell Wideman Ii,
2547 Floridiane Dr,
Melbourne, FL 32935-2816
Ph: (321) 271-8115 | Dennis Darnell Wideman Ii,
1887 Se Port St Lucie Blvd,
Port St Lucie, FL 34952-5530
Ph: (772) 463-0444 |
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