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NPI Code Detail

MEDICARE: DR. JEFFREY WEINHEIMER D.O.

MEDICARE: DR. JEFFREY WEINHEIMER D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0401XAddiction Medicine (Family Medicine) PhysicianDOOS13485FL
2207QA0401XAddiction Medicine (Family Medicine) PhysicianOS13485FL
3207Q00000XFamily Medicine PhysicianOS13485FL
4207Q00000XFamily Medicine PhysicianUO3376FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OS13485OTHERFLDO

General Provider Information

NPI Number : 1043645146
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY WEINHEIMER D.O.
Provider Business Mailing Address
First Line : 6000 LAKE ELLENOR DR
Second Line :
City : ORLANDO
State : FL
Zip : 32809-4615
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6000 LAKE ELLENOR DR
Second Line :
City : ORLANDO
State : FL
Zip : 32809-4615
Country : US
Telephone Number : 407-636-6196
Fax Number : 407-438-0840
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2013
Last Update Date : 10/20/2020

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