Provider Demographics
NPI:1639145337
Name:WEITZ, MICHAEL ALAN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALAN
Last Name:WEITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7190 SW 87TH AVE
Mailing Address - Street 2:304
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173
Mailing Address - Country:US
Mailing Address - Phone:305-661-2299
Mailing Address - Fax:305-666-0458
Practice Address - Street 1:7190 SW 87TH AVE
Practice Address - Street 2:304
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2512
Practice Address - Country:US
Practice Address - Phone:305-661-2299
Practice Address - Fax:305-666-0458
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2015-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0029165207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL065309800Medicaid
FLD82607Medicare UPIN
FL065309800Medicaid