Provider Demographics
NPI:1578591012
Name:WEINER, NEIL J (DO)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:J
Last Name:WEINER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2455 HOLLYWOOD BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6605
Mailing Address - Country:US
Mailing Address - Phone:954-453-1113
Mailing Address - Fax:954-929-9513
Practice Address - Street 1:2455 HOLLYWOOD BLVD STE 300
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6605
Practice Address - Country:US
Practice Address - Phone:954-453-1113
Practice Address - Fax:954-929-9513
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2021-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 8273207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266585900Medicaid
FLH84431Medicare UPIN
FL57632Medicare PIN