MEDICARE: RONALD WIEWORA M.D

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	207R00000X	Internal Medicine Physician	ME 39948	FL
2	2083P0901X	Public Health & General Preventive Medicine Physician	ME39948	FL

General Provider Information

NPI Number	:	1295949758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD WIEWORA M.D

Provider Business Mailing Address
First Line	:	324 DATURA ST
Second Line	:	SUITE 401
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-5414
Country	:	US
Telephone Number	:	561-659-1270
Fax Number	:	561-802-3968

Provider Business Practice Location Address
First Line	:	324 DATURA ST
Second Line	:	SUITE 401
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-5414
Country	:	US
Telephone Number	:	561-659-1270
Fax Number	:	561-802-3968

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	09/11/2025

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