Provider Demographics
NPI:1891818787
Name:WEINGARDEN, GERALD (DO)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
Last Name:WEINGARDEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 CRANES POINTE WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-3157
Mailing Address - Country:US
Mailing Address - Phone:561-626-5635
Mailing Address - Fax:561-493-8430
Practice Address - Street 1:8033 CRANES POINTE WAY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33412-3157
Practice Address - Country:US
Practice Address - Phone:561-626-5635
Practice Address - Fax:561-493-8430
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI004911207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE25948Medicare UPIN