Provider Demographics
NPI:1386631679
Name:WEISSMAN, RICHARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:WEISSMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10146 SW 93RD PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3085
Mailing Address - Country:US
Mailing Address - Phone:305-274-8987
Mailing Address - Fax:305-274-9767
Practice Address - Street 1:10146 SW 93RD PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-3085
Practice Address - Country:US
Practice Address - Phone:305-274-8987
Practice Address - Fax:305-274-9767
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0892213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist