Provider Demographics
NPI:1508926965
Name:WEISS, DELIA B (MD)
Entity Type:Individual
Prefix:DR
First Name:DELIA
Middle Name:B
Last Name:WEISS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SE 4TH AVE
Mailing Address - Street 2:
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 S.E. 4TH AVENUE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:USA
Practice Address - Zip Code:33483
Practice Address - Country:UM
Practice Address - Phone:561-243-8783
Practice Address - Fax:866-212-8783
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94993207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5Y631Medicare ID - Type Unspecified
G53553Medicare UPIN