Healthcare Provider Details

I. General information

NPI: 1316295447
Provider Name (Legal Business Name): JOSE R WEISINGER, MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2012
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 SW 87TH CT STE 215
MIAMI FL
33176-2288
US

IV. Provider business mailing address

9000 SW 87TH CT STE 215
MIAMI FL
33176-2288
US

V. Phone/Fax

Practice location:
  • Phone: 305-274-4800
  • Fax: 305-279-6462
Mailing address:
  • Phone: 305-274-4800
  • Fax: 305-279-6462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number0037294
License Number StateFL

VIII. Authorized Official

Name: DR. JOSE RUBEN WEISINGER
Title or Position: PRESIDENT
Credential: MD
Phone: 305-274-4800