MEDICARE: GILBERT R WEINER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	DS1649	FL

General Provider Information

NPI Number	:	1134137128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILBERT R WEINER DO

Provider Business Mailing Address
First Line	:	1130 BAYVIEW DR
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-2505
Country	:	US
Telephone Number	:	954-764-8911
Fax Number	:	954-764-2150

Provider Business Practice Location Address
First Line	:	1130 BAYVIEW DR
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-2505
Country	:	US
Telephone Number	:	954-764-8911
Fax Number	:	954-764-2150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/21/2022

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Directions to “ GILBERT R WEINER DO” Practice Location

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