Provider Demographics
NPI:1003817693
Name:WEISSTEIN, JASON SCOTT (MD,MPH)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:SCOTT
Last Name:WEISSTEIN
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 SE SALERNO RD STE 110
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-6572
Mailing Address - Country:US
Mailing Address - Phone:772-419-3974
Mailing Address - Fax:
Practice Address - Street 1:2150 SE SALERNO RD STE 110
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-6572
Practice Address - Country:US
Practice Address - Phone:772-419-3974
Practice Address - Fax:772-223-5705
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71367207X00000X
FLME104071207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA71367OtherCA MEDICAL BOARD
CAFG825ZOtherMEDICARE PTAN
FLCA219ZMedicare PIN
CAFG825ZOtherMEDICARE PTAN
AZ82020Medicare ID - Type Unspecified