Provider Demographics
NPI:1093148272
Name:DR. PAUL A. WEINER, PA
Entity Type:Organization
Organization Name:DR. PAUL A. WEINER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-265-5424
Mailing Address - Street 1:15300 JOG RD
Mailing Address - Street 2:SUITE # 204
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2162
Mailing Address - Country:US
Mailing Address - Phone:561-265-5424
Mailing Address - Fax:561-265-5418
Practice Address - Street 1:15300 JOG RD
Practice Address - Street 2:SUITE # 204
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2162
Practice Address - Country:US
Practice Address - Phone:561-265-5424
Practice Address - Fax:561-265-5418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2873213E00000X, 213EP1101X, 213ER0200X, 213ES0000X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Multi-Specialty
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiologyGroup - Multi-Specialty
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty