Provider Demographics
NPI:1417321357
Name:BAPTIST HEALTH MEDICAL PLAZA COUNTRY WALK
Entity Type:Organization
Organization Name:BAPTIST HEALTH MEDICAL PLAZA COUNTRY WALK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:WEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-596-7992
Mailing Address - Street 1:13500 SW 152ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1111
Mailing Address - Country:US
Mailing Address - Phone:786-596-4300
Mailing Address - Fax:
Practice Address - Street 1:13500 SW 152ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1111
Practice Address - Country:US
Practice Address - Phone:786-596-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAPTIST OUTPATIENT SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care