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General NPI Number Information
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NPI Number | 1154626786
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Entity Type | Organization
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Legal Business Name | MITCHELL WEINER MD PA
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Dates
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Enumeration Date | 01/12/2011
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 7143 STATE ROAD 54 SUITE 205
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-6104
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Country | US
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Telephone | 727-919-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 7143 STATE ROAD 54 SUITE 205
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-6104
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Country | US
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Telephone | 727-919-3000
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MITCHELL A WEINER
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Credential | MD
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Telephone | 727-919-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME369667
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License Number State | FL
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