Provider Demographics
NPI:1821884560
Name:WEIMER, DEREK STEPHEN
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:STEPHEN
Last Name:WEIMER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 CASUARINA CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6403
Mailing Address - Country:US
Mailing Address - Phone:954-980-5353
Mailing Address - Fax:
Practice Address - Street 1:501 CASUARINA CONCOURSE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33143-6403
Practice Address - Country:US
Practice Address - Phone:954-980-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program