Provider Demographics
NPI:1609851419
Name:WEINER, HILTON STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:HILTON
Middle Name:STEPHEN
Last Name:WEINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1005 MAR WALT DR
Mailing Address - Street 2:HOSPITALIST DEPARTMENT
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-6707
Mailing Address - Country:US
Mailing Address - Phone:850-863-8100
Mailing Address - Fax:850-862-2303
Practice Address - Street 1:1005 MAR WALT DR
Practice Address - Street 2:HOSPITALIST DEPARTMENT
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6707
Practice Address - Country:US
Practice Address - Phone:850-863-8100
Practice Address - Fax:850-862-2303
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47692207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062671600Medicaid
FL10616OtherBCBSFL
E53000Medicare UPIN
FL062671600Medicaid