Individual
MR. BRUCE A WEINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7171 N DALE MABRY HWY, TAMPA, FL 33614-2630
(813) 558-8070
Mailing address
1239 E MAIN ST, CARBONDALE, IL 62901-3175
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209020770
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
2133502
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022889000
—
FL
01
—
214881
MEDICARE GROUP PTAN
IL
Enumeration date
06/22/2005
Last updated
12/16/2025
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