Provider Demographics
NPI:1205891496
Name:WEINER, STEVEN L (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:WEINER
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 1:8025 W MCNAB RD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-3219
Mailing Address - Country:US
Mailing Address - Phone:954-720-1107
Mailing Address - Fax:954-726-3885
Practice Address - Street 1:8025 W MCNAB RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-3219
Practice Address - Country:US
Practice Address - Phone:954-720-1107
Practice Address - Fax:954-720-5567
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6691111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380535200Medicaid
FL55140Medicare ID - Type Unspecified
FL380535200Medicaid