Healthcare Provider Details

I. General information

NPI: 1003817693
Provider Name (Legal Business Name): JASON SCOTT WEISSTEIN M.D.,M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 SE SALERNO RD STE 110
STUART FL
34997-6572
US

IV. Provider business mailing address

2150 SE SALERNO RD STE 110
STUART FL
34997-6572
US

V. Phone/Fax

Practice location:
  • Phone: 772-419-3974
  • Fax: 772-223-5705
Mailing address:
  • Phone: 772-419-3974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA71367
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME104071
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberME104071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: