Provider Demographics
NPI:1841568730
Name:WEILAND, SCOTT A (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:WEILAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6622 WILLOW PARK DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-9016
Mailing Address - Country:US
Mailing Address - Phone:239-745-5561
Mailing Address - Fax:239-631-5621
Practice Address - Street 1:6622 WILLOW PARK DR
Practice Address - Street 2:SUITE 202
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-9016
Practice Address - Country:US
Practice Address - Phone:239-745-5561
Practice Address - Fax:239-631-5621
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006965111NS0005X
FLCH11220111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHY456ZMedicare PIN