MEDICARE: DR. MICHAEL WEISS DO

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	OS6080	FL
2	207X00000X	Orthopaedic Surgery Physician	DR.0056721	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265421184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL WEISS DO

Provider Business Mailing Address
First Line	:	1885 MARINA MILE BLVD STE 103
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-2243
Country	:	US
Telephone Number	:	888-655-7473
Fax Number	:

Provider Business Practice Location Address
First Line	:	1885 MARINA MILE BLVD STE 103
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-2243
Country	:	US
Telephone Number	:	888-655-7473
Fax Number	:

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

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	08/02/2023

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Directions to “ DR. MICHAEL WEISS DO” Practice Location

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