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General NPI Number Information
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NPI Number | 1447112024
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Entity Type | Individual
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Provider Name | MR. EDWARD WEIR
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Gender | Male
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 11438 IVY FLOWER LOOP
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City | RIVERVIEW
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State | FL
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Zip | 33578-9472
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Country | US
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Telephone | 813-479-5387
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Fax |
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Provider Business Mailing Address
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Address Line | 11438 IVY FLOWER LOOP
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City | RIVERVIEW
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State | FL
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Zip | 33578-9472
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Country | US
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Telephone | 813-479-5387
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | W624-440-22-500-0
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License Number State | FL
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