Healthcare Provider Details

I. General information

NPI: 1093927733
Provider Name (Legal Business Name): ALLEN S. WEISS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 7TH ST N
NAPLES FL
34102-5754
US

IV. Provider business mailing address

350 7TH ST N
NAPLES FL
34102-5754
US

V. Phone/Fax

Practice location:
  • Phone: 239-436-5100
  • Fax: 239-436-5914
Mailing address:
  • Phone: 239-436-5100
  • Fax: 239-436-5914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME0029349
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: