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General NPI Number Information
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NPI Number | 1043534670
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Entity Type | Organization
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Legal Business Name | MARK E. WEIGLEY, M.D., P.A.
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Dates
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Enumeration Date | 03/25/2010
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Last Update Date | 03/25/2010
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Provider Practice Location Address
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Address Line | 685 PALM SPRINGS DR SUITE 1A
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-7853
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Country | US
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Telephone | 407-339-5959
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Fax | 407-339-5951
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Provider Business Mailing Address
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Address Line | 685 PALM SPRINGS DR SUITE 1A
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-7853
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Country | US
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Telephone | 407-339-5959
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Fax | 407-339-5951
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK EDWARD WEIGLEY
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Credential | M.D.
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Telephone | 407-339-5959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME002614
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License Number State | FL
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