Provider Demographics
NPI:1114534062
Name:WEISMAN, GERALD (ATP, RET)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:WEISMAN
Suffix:
Gender:M
Credentials:ATP, RET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 SALMON DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-2630
Mailing Address - Country:US
Mailing Address - Phone:802-734-1021
Mailing Address - Fax:
Practice Address - Street 1:3949 SALMON DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-2630
Practice Address - Country:US
Practice Address - Phone:802-734-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZB0301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherBiomedical Engineering
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist