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General NPI Number Information
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NPI Number | 1316871940
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Entity Type | Individual
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Provider Name | NATHANIEL PRESLEY WEAVER
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Gender | Male
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/09/2026
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Provider Practice Location Address
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Address Line | 4114 WOODLANDS PKWY STE 500
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City | PALM HARBOR
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State | FL
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Zip | 34685-3450
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Country | US
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Telephone | 727-942-5189
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Fax | 727-390-8309
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Provider Business Mailing Address
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Address Line | 1766 WOOD BROOK ST
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-7510
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Country | US
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Telephone | 727-450-9933
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | FL
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