MEDICARE: DR. PETER JOHN WEISS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	ME49655	FL
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	ME49655	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME49655	OTHER	FL	STATE LICENSE

General Provider Information

NPI Number	:	1043219959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER JOHN WEISS M.D.

Provider Business Mailing Address
First Line	:	133 BENMORE DR STE 200
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-4111
Country	:	US
Telephone Number	:	407-646-7070
Fax Number	:	407-646-7747

Provider Business Practice Location Address
First Line	:	133 BENMORE DR STE 200
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-4111
Country	:	US
Telephone Number	:	407-646-7070
Fax Number	:	407-646-7747

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	03/28/2019

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Directions to “ DR. PETER JOHN WEISS M.D.” Practice Location

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