Provider Demographics
NPI:1861493116
Name:WEISS, DAVID SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4700 SHERIDAN ST
Mailing Address - Street 2:SUITE M
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3420
Mailing Address - Country:US
Mailing Address - Phone:954-961-8400
Mailing Address - Fax:954-961-8401
Practice Address - Street 1:11011 SHERIDAN ST
Practice Address - Street 2:SUITE 109
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33026-1505
Practice Address - Country:US
Practice Address - Phone:954-961-8400
Practice Address - Fax:954-961-8401
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2016-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME58375207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373225800Medicaid
FL373225800Medicaid
FL18751ZMedicare ID - Type UnspecifiedMEDICARE NUMBER