Provider Demographics
NPI:1033146055
Name:WEINSHEL, DAVID A (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:WEINSHEL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 OLD LOGGERS WAY
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-4312
Mailing Address - Country:US
Mailing Address - Phone:203-482-5074
Mailing Address - Fax:
Practice Address - Street 1:4255 US 1 S STE 10
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-7000
Practice Address - Country:US
Practice Address - Phone:904-240-0565
Practice Address - Fax:904-240-0471
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT024742207R00000X
FLME161987207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB83673Medicare UPIN