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Individual

IRA LEWIS WEINER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
345 MOONLIGHT BAY DR, PANAMA CITY BEACH, FL 32407-2860
(850) 236-8862
(850) 236-8862
Mailing address
345 MOONLIGHT BAY DRIVE, PANAMA CITY BEACH, FL 32407
(850) 236-8862
(850) 236-8862

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME82807
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
81168
BCBSF PROV#
FL
01
ME82807
MEDICAL LICENSE #
FL
Enumeration date
07/07/2005
Last updated
03/07/2023
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