MEDICARE: DARYL D WIER MD PA

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
1	208600000X	Surgery Physician	44599	FL

General Provider Information

NPI Number	:	1326248626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DARYL D WIER MD PA

Provider Business Mailing Address
First Line	:	930 ASHINGTON PL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6905
Country	:	US
Telephone Number	:	407-709-3564
Fax Number	:

Provider Business Practice Location Address
First Line	:	1802 BELLEVUE AVE
Second Line	:	SUITE #102
City	:	ORLANDO
State	:	FL
Zip	:	32806-2933
Country	:	US
Telephone Number	:	407-841-4220
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. NOEL WIER
Credential	:
Telephone Number	:	407-841-4220

Provider Enumeration Date	:	07/24/2007
Last Update Date	:	10/30/2007

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