Organization Active NPI

Mark S Willner MD PA

  • Psychiatry Physician
  • Sunrise, FL
National Provider Identifier
1760675193
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MARK S WILLNER MD PA
Practice address
14201 W Sunrise Blvd
Suite 208
Sunrise, FL 33323-3207
Phone
(954) 851-9690
Fax
(954) 851-9688
NPI assigned
Aug 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark S. Willner, M.D.
Title
President
Phone
(954) 851-9690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

14201 W Sunrise Blvd
Suite 208
Sunrise, FL 33323-3207

Mailing address

3820 Windmill Lakes Rd
Weston, FL 33332-2107
Phone (954) 851-9690

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1760675193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 WINDMILL LAKES RD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333322107",
            "telephone_number": "954-851-9690",
            "fax_number": "954-851-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 W SUNRISE BLVD",
            "address_2": "SUITE 208",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333233207",
            "telephone_number": "954-851-9690",
            "fax_number": "954-851-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S WILLNER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "WILLNER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-851-9690",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.