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General NPI Number Information
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NPI Number | 1760633473
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Entity Type | Organization
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Legal Business Name | RICHARD B WEISBERG PA
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Dates
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Enumeration Date | 10/01/2008
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 1141 SE INDIAN ST STE 101
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City | STUART
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State | FL
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Zip | 34997-5764
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Country | US
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Telephone | 772-221-7789
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Fax | 772-221-8584
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Provider Business Mailing Address
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Address Line | 3511 SE WILLOUGHBY BLVD
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City | STUART
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State | FL
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Zip | 34994-5059
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Country | US
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Telephone | 772-221-7789
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Fax | 772-221-8584
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RICHARD B WEISBERG
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Credential | D.O
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Telephone | 772-221-7789
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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 | OS6866
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License Number State | FL
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