Healthcare Provider Details

I. General information

NPI: 1639198567
Provider Name (Legal Business Name): RUSSEL DARREN WEISZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 LINTON BLVD BUILDING A SUITE 201
DELRAY BEACH FL
33445-6584
US

IV. Provider business mailing address

4800 LINTON BLVD BUILDING A SUITE 201
DELRAY BEACH FL
33445-6584
US

V. Phone/Fax

Practice location:
  • Phone: 561-496-6622
  • Fax: 561-496-3835
Mailing address:
  • Phone: 561-496-6622
  • Fax: 561-496-3835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number94146
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number94146
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME82067
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: