Healthcare Provider Details

I. General information

NPI: 1316884521
Provider Name (Legal Business Name): FRANK EDWARD WEITEKAMP LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1277 N SEMORAN BLVD STE 112
ORLANDO FL
32807-3573
US

IV. Provider business mailing address

15544 W COLONIAL DR
WINTER GARDEN FL
34787-9556
US

V. Phone/Fax

Practice location:
  • Phone: 800-457-4573
  • Fax: 800-443-6422
Mailing address:
  • Phone: 800-457-4573
  • Fax: 800-443-6422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW26297
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: