Healthcare Provider Details

I. General information

NPI: 1598297129
Provider Name (Legal Business Name): JESSICA ESTHER WEISS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2017
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COASTAL PULMONARY AND CRITICAL CARE, PLC 2639 DR. ML KING JR. STREET NO.
ST. PETERSBURG FL
33704-2733
US

IV. Provider business mailing address

2639 DR ML KING JR ST N
ST PETERSBURG FL
33704-2733
US

V. Phone/Fax

Practice location:
  • Phone: 727-822-6661
  • Fax: 278-231-3347
Mailing address:
  • Phone: 727-822-6661
  • Fax: 278-231-3347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberOS19990
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberOS19990
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: