Organization
MAGNOLIA PODIATRY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD L WEINER D.P.M. (PRESIDENT)
(954) 721-6010
Entity
Organization
Contact information
Practice address
7727 SOUTHAMPTON TER, SUITE 412-F, TAMARAC, FL 33321-9101
(954) 721-6010
Mailing address
7727 SOUTHAMPTON TER, SUITE 412-F, TAMARAC, FL 33321-9101
(954) 721-6010
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3137
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340507900
—
FL
Enumeration date
07/03/2007
Last updated
12/30/2011
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