Provider Demographics
NPI:1902372584
Name:WEISS, MEIRA NECHAMA FREIDEN (DPT)
Entity Type:Individual
Prefix:
First Name:MEIRA
Middle Name:NECHAMA FREIDEN
Last Name:WEISS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 PINE TREE DR APT 1126
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3616
Mailing Address - Country:US
Mailing Address - Phone:901-598-1144
Mailing Address - Fax:
Practice Address - Street 1:4101 PINE TREE DR APT 1126
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3616
Practice Address - Country:US
Practice Address - Phone:901-598-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL32122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist