Provider Demographics
NPI:1619974342
Name:WEISS, DANIEL NATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:NATHAN
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 N FEDERAL HWY
Mailing Address - Street 2:JIM MORAN HEART CENTER, SUITE 502
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4603
Mailing Address - Country:US
Mailing Address - Phone:954-772-1080
Mailing Address - Fax:954-772-7306
Practice Address - Street 1:4725 N FEDERAL HWY
Practice Address - Street 2:JIM MORAN HEART CENTER, SUITE 502
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4603
Practice Address - Country:US
Practice Address - Phone:954-772-1080
Practice Address - Fax:954-772-7306
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0066594207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
25439Medicare ID - Type Unspecified
E69240Medicare UPIN