Healthcare Provider Details

I. General information

NPI: 1316723885
Provider Name (Legal Business Name): PERI WEISSMARK APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15340 S JOG RD STE 215
DELRAY BEACH FL
33446-2170
US

IV. Provider business mailing address

6626 NW 112TH AVE
PARKLAND FL
33076-3714
US

V. Phone/Fax

Practice location:
  • Phone: 561-559-9800
  • Fax:
Mailing address:
  • Phone: 954-895-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9537662
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11025880
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: