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General NPI Number Information
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NPI Number | 1568568459
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Entity Type | Individual
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Provider Name | RICHARD S WEISS D.O.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 3918 VIA POINCIANA STE 8
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City | LAKE WORTH
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State | FL
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Zip | 33467-2991
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Country | US
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Telephone | 561-996-4370
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Fax | 561-641-2484
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Provider Business Mailing Address
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Address Line | 5700 LAKE WORTH RD STE 204
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City | GREENACRES
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State | FL
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Zip | 33463-4727
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Country | US
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Telephone | 561-966-7703
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Fax | 561-649-7024
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MB041575
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS004765L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS13555
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License Number State | FL
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