MEDICARE: DR. DANIEL NATHAN 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	207RC0001X	Clinical Cardiac Electrophysiology Physician	ME0066594	FL

General Provider Information

NPI Number	:	1619974342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL NATHAN WEISS M.D.

Provider Business Mailing Address
First Line	:	4725 N FEDERAL HWY
Second Line	:	JIM MORAN HEART CENTER, SUITE 502
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4603
Country	:	US
Telephone Number	:	954-772-1080
Fax Number	:	954-772-7306

Provider Business Practice Location Address
First Line	:	4725 N FEDERAL HWY
Second Line	:	JIM MORAN HEART CENTER, SUITE 502
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4603
Country	:	US
Telephone Number	:	954-772-1080
Fax Number	:	954-772-7306

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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