Provider Demographics
NPI:1639581770
Name:WEISS, ERIC SPENCER (MD)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:SPENCER
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 1:2320 NE 9TH STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304
Mailing Address - Country:US
Mailing Address - Phone:954-563-4500
Mailing Address - Fax:954-530-0399
Practice Address - Street 1:2320 NE 9TH ST STE 300
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-3590
Practice Address - Country:US
Practice Address - Phone:412-215-3359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT206879208600000X
FLME1627922086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery