Provider Demographics
NPI:1417216623
Name:WEIL, ASHLEY MEREDITH (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MEREDITH
Last Name:WEIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4244 AVALON BLVD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-2808
Mailing Address - Country:US
Mailing Address - Phone:850-494-4600
Mailing Address - Fax:904-450-6401
Practice Address - Street 1:4244 AVALON BLVD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32583-2808
Practice Address - Country:US
Practice Address - Phone:850-494-4600
Practice Address - Fax:904-450-6401
Is Sole Proprietor?:No
Enumeration Date:2012-05-08
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME143068207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program