Healthcare Provider Details

I. General information

NPI: 1972537348
Provider Name (Legal Business Name): DONALD T WEED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1666 NW 10 AVE
MIAMI FL
33101-6960
US

IV. Provider business mailing address

1666 NW 10 AVE BOX 016960 (M851)
MIAMI FL
33101-6960
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-5224
  • Fax: 305-243-8470
Mailing address:
  • Phone: 305-585-5224
  • Fax: 305-243-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME70925
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberME70925
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: