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General NPI Number Information
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NPI Number | 1871537027
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Entity Type | Individual
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Provider Name | RAYMOND LOUIS WEIAND D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 61 MEMORIAL MEDICAL PKWY STE 2801
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City | PALM COAST
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State | FL
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Zip | 32164-5999
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Country | US
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Telephone | 386-586-1910
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Fax | 386-586-1939
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Provider Business Mailing Address
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Address Line | 61 MEMORIAL MEDICAL PKWY STE 2801
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City | PALM COAST
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State | FL
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Zip | 32164-5999
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Country | US
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Telephone | 386-586-1910
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Fax | 386-586-1939
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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 | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | MBO48543NJ
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | OS14386
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | OS14386
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License Number State | FL
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