Provider Demographics
NPI:1073512521
Name:WEINER, HOWARD M (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:M
Last Name:WEINER
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2385 NW EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-8579
Mailing Address - Country:US
Mailing Address - Phone:561-451-0200
Mailing Address - Fax:561-451-0700
Practice Address - Street 1:2385 NW EXECUTIVE CENTER DR
Practice Address - Street 2:SUITE 102
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-8579
Practice Address - Country:US
Practice Address - Phone:561-451-0200
Practice Address - Fax:561-451-0700
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2007-11-20
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
FLME0053447207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD51927Medicare UPIN
FL07460Medicare PIN