Provider Demographics
NPI:1518240647
Name:WEISLER, JEFF MARK (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:MARK
Last Name:WEISLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11064 BRANDYWINE LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-4888
Mailing Address - Country:US
Mailing Address - Phone:954-551-4697
Mailing Address - Fax:954-972-9738
Practice Address - Street 1:1800 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-1324
Practice Address - Country:US
Practice Address - Phone:954-972-0313
Practice Address - Fax:954-972-9738
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS15275183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist