Healthcare Provider Details

I. General information

NPI: 1639145337
Provider Name (Legal Business Name): MICHAEL ALAN WEITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7190 SW 87TH AVE 304
MIAMI FL
33173-2512
US

IV. Provider business mailing address

7190 SW 87TH AVE 304
MIAMI FL
33173
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-2299
  • Fax: 305-666-0458
Mailing address:
  • Phone: 305-661-2299
  • Fax: 305-666-0458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME0029165
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: