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General NPI Number Information
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NPI Number | 1073564910
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Entity Type | Individual
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Provider Name | STEPHEN G WEISS II MD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 685 PEACHWOOD DR
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City | DELAND
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State | FL
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Zip | 32720-0804
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Country | US
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Telephone | 386-736-3463
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Fax |
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Provider Business Mailing Address
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Address Line | 12109 COUNTY ROAD 103
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City | OXFORD
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State | FL
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Zip | 34484-2951
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Country | US
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Telephone | 352-205-8981
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Fax | 352-391-6498
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME78669
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License Number State | FL
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