Provider Demographics
NPI:1093030892
Name:DELIA WEISS MD PA
Entity Type:Organization
Organization Name:DELIA WEISS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-243-8783
Mailing Address - Street 1:1 SE 4TH AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4551
Mailing Address - Country:US
Mailing Address - Phone:561-243-8783
Mailing Address - Fax:866-212-8783
Practice Address - Street 1:1 SE 4TH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4551
Practice Address - Country:US
Practice Address - Phone:561-243-8783
Practice Address - Fax:866-212-8783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1508926965OtherNPI
G53553Medicare UPIN