MEDICARE: DR. NEIL J WEINER 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
1	207RN0300X	Nephrology Physician	OS 8273	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578591012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL J WEINER D.O.

Provider Business Mailing Address
First Line	:	2455 HOLLYWOOD BLVD STE 300
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6605
Country	:	US
Telephone Number	:	954-453-1113
Fax Number	:	954-929-9513

Provider Business Practice Location Address
First Line	:	2455 HOLLYWOOD BLVD STE 300
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-6605
Country	:	US
Telephone Number	:	954-453-1113
Fax Number	:	954-929-9513

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	12/30/2021

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