1346660859 NPI number — DR. BRIAN LAWRENCE WEINERT DDS

Table of content: DR. BRIAN LAWRENCE WEINERT DDS (NPI 1346660859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346660859 NPI number — DR. BRIAN LAWRENCE WEINERT DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEINERT
Provider First Name:
BRIAN
Provider Middle Name:
LAWRENCE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346660859
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1460 E RED BUG RD
Provider Second Line Business Mailing Address:
SUITE 1000
Provider Business Mailing Address City Name:
OVIEDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32765-6527
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-971-1116
Provider Business Mailing Address Fax Number:
407-971-7633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1460 E RED BUG RD
Provider Second Line Business Practice Location Address:
SUITE 1000
Provider Business Practice Location Address City Name:
OVIEDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32765-6527
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-971-1116
Provider Business Practice Location Address Fax Number:
407-971-7633
Provider Enumeration Date:
04/23/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DN0013511 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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