MEDICARE: DR. STEPHEN DAVID WEISSMAN DPM

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	213E00000X	Podiatrist	PO3352	FL

General Provider Information

NPI Number	:	1124201173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN DAVID WEISSMAN DPM

Provider Business Mailing Address
First Line	:	1333 3RD AVE S
Second Line	:	STE 504
City	:	NAPLES
State	:	FL
Zip	:	34102-6538
Country	:	US
Telephone Number	:	239-260-5181
Fax Number	:	239-260-5183

Provider Business Practice Location Address
First Line	:	1333 3RD AVE S
Second Line	:	STE 504
City	:	NAPLES
State	:	FL
Zip	:	34102-6538
Country	:	US
Telephone Number	:	239-260-5181
Fax Number	:	239-260-5183

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

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	01/14/2020

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