Provider Demographics
NPI:1043303464
Name:WEISS, LAREYNE (PT)
Entity Type:Individual
Prefix:MS
First Name:LAREYNE
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LAREYNE
Other - Middle Name:
Other - Last Name:MAHMOODI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1449 W YAMATO RD STE 2
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4471
Mailing Address - Country:US
Mailing Address - Phone:561-826-3808
Mailing Address - Fax:561-826-3808
Practice Address - Street 1:1424 SEAGRAPE CIR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-2724
Practice Address - Country:US
Practice Address - Phone:954-217-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT19287225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist