MEDICARE: BRIAN L WEINERT DDS 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	1223G0001X	General Practice Dentistry	DN0013511	FL

General Provider Information

NPI Number	:	1396808952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIAN L WEINERT DDS PA

Provider Business Mailing Address
First Line	:	1460 E RED BUG RD
Second Line	:	SUITE 1000
City	:	OVIEDO
State	:	FL
Zip	:	32765-6527
Country	:	US
Telephone Number	:	407-971-1116
Fax Number	:	407-971-7633

Provider Business Practice Location Address
First Line	:	1460 E RED BUG RD
Second Line	:	SUITE 1000
City	:	OVIEDO
State	:	FL
Zip	:	32765-6527
Country	:	US
Telephone Number	:	407-971-1116
Fax Number	:	407-971-7633

Authorized Official
Title or Position	:	PRES
Name	:	DR. BRIAN LAWRENCE WEINERT
Credential	:	D.D.S
Telephone Number	:	407-971-1116

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	05/28/2013

Similar Medicare Providers

1346660859 — DR. BRIAN LAWRENCE WEINERT DDS
Practice Location Address:

1460 E RED BUG RD , SUITE 1000
OVIEDO, FL
32765-6527

Practice Phone: 407-971-1116
Practice Fax: 407-971-7633

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