MARK RICHARD WEATHERLY M.D. NPI 1881703650

NPI Information

NPI: 1881703650
Provider Name: MARK RICHARD WEATHERLY, M.D.
Classification: Pediatrics - 2080P0214X
Entity Type: Individual

Specialization: Pediatric Pulmonology

PECOS Registration: Yes

Address:
60 W GORE STREET
ORLANDO, FL
ZIP 32806
Phone: (407) 351-5384
Get Directions

Mark Richard Weatherly, M.D. is a pediatric pulmonology pediatrics in Orlando, FL. The provider is a pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques. Mark Richard Weatherly, M.D. NPI is 1881703650. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

60 W GORE STREET
ORLANDO, FL
ZIP 32806-101
Phone: (407) 351-5384
Fax: (407) 445-0321

The NPI 1881703650 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 11/10/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080P0214X	Pediatrics	Pediatric Pulmonology	ME62498	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1419354	MEDICAID	LOUISIANA
2	17789T	MEDICARE PIN	FLORIDA
3	7616163	MEDICAID	NORTH CAROLINA
4	370776800	MEDICAID	FLORIDA
5	ME62498	OTHER	FLORIDA	MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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