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General NPI Number Information
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NPI Number | 1841005899
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Entity Type | Organization
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Legal Business Name | ORACLE SPINE AND ORTHOPEDICS, PA
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 10600 GRIFFIN RD STE 107
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City | DAVIE
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State | FL
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Zip | 33328-3208
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Country | US
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Telephone | 954-295-9753
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Fax | 954-301-3901
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Provider Business Mailing Address
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Address Line | 772 NW 82ND TER
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City | PLANTATION
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State | FL
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Zip | 33324-1235
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Country | US
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Telephone | 954-328-9441
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Fax | 954-301-3901
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHAEL C WEISS
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Credential | DO
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Telephone | 954-295-9753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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