MEDICARE: DR. MICHAEL IVAN WEISS MD

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	208M00000X	Hospitalist Physician	ME82245	FL
2	207V00000X	Obstetrics & Gynecology Physician	ME82245	FL

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
2	05006	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922094986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL IVAN WEISS MD

Provider Business Mailing Address
First Line	:	7050 GALL BLVD
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33541-1347
Country	:	US
Telephone Number	:	813-782-8761
Fax Number	:	813-783-6038

Provider Business Practice Location Address
First Line	:	7050 GALL BLVD
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33541-1347
Country	:	US
Telephone Number	:	813-782-8761
Fax Number	:	813-783-6038

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	08/21/2025

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