Provider Demographics
NPI:1093987497
Name:ELLIOTT B WEINGER MD PA
Entity Type:Organization
Organization Name:ELLIOTT B WEINGER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:B
Authorized Official - Last Name:WEINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-454-3335
Mailing Address - Street 1:1724 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4611
Mailing Address - Country:US
Mailing Address - Phone:954-454-3335
Mailing Address - Fax:954-454-1991
Practice Address - Street 1:1724 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4611
Practice Address - Country:US
Practice Address - Phone:954-454-3335
Practice Address - Fax:954-454-1991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 32539207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAK339Medicare PIN