Provider Demographics
NPI:1003036633
Name:WEINER, PAUL (CERTIFIED PEDORTHIST)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:WEINER
Suffix:
Gender:M
Credentials:CERTIFIED PEDORTHIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7036 W PALMETTO PARK RD STE 59
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3404
Mailing Address - Country:US
Mailing Address - Phone:561-338-3838
Mailing Address - Fax:
Practice Address - Street 1:7036 W PALMETTO PARK RD STE 59
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3404
Practice Address - Country:US
Practice Address - Phone:561-338-3838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter