MEDICARE: ALLA WEISZ 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	207Q00000X	Family Medicine Physician	01055029	IN

General Provider Information

NPI Number	:	1972580207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLA WEISZ M.D.

Provider Business Mailing Address
First Line	:	7143 WINDING BAY LN
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-3039
Country	:	US
Telephone Number	:	317-985-9599
Fax Number	:	561-421-3799

Provider Business Practice Location Address
First Line	:	3375 BURNS RD STE 207
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4361
Country	:	US
Telephone Number	:	561-802-7999
Fax Number	:	561-421-3799

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	08/29/2019

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