Healthcare Provider Details

I. General information

NPI: 1861886426
Provider Name (Legal Business Name): JAMES DAVID WEINBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2015
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2590 HEALING WAY STE 310
WESLEY CHAPEL FL
33543-5497
US

IV. Provider business mailing address

26901 BEAUMONT BLVD STE 3D
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 813-333-1186
  • Fax:
Mailing address:
  • Phone: 947-522-1862
  • Fax: 947-522-0307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME155770
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME155770
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: