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Individual

NATHAN ZACHARY WEAGRAFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-5600
Mailing address
500 WINDERLEY PL, SUITE 115, MAITLAND, FL 32751-7247

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME123030
FL
282N00000X
General Acute Care Hospital
MT200251
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
014864400
FL
Enumeration date
07/12/2011
Last updated
12/07/2015
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