Healthcare Provider Details

I. General information

NPI: 1124291885
Provider Name (Legal Business Name): DANIEL AARON WEINBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2008
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1542 KINGSLEY AVE STE 136-137
ORANGE PARK FL
32073-4586
US

IV. Provider business mailing address

1542 KINGSLEY AVE STE 136-137
ORANGE PARK FL
32073-4586
US

V. Phone/Fax

Practice location:
  • Phone: 239-690-6906
  • Fax:
Mailing address:
  • Phone: 239-690-6906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME100019
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME100019
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: