Provider Demographics
NPI:1255388161
Name:WEBER, STEVEN JAY (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JAY
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1050 NW 15TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1375
Mailing Address - Country:US
Mailing Address - Phone:561-393-8224
Mailing Address - Fax:561-367-9727
Practice Address - Street 1:1050 NW 15TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1375
Practice Address - Country:US
Practice Address - Phone:561-393-8224
Practice Address - Fax:561-367-9727
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME123416207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0023403000OtherKEYSTONE HEALTHPLAN EAST
PA1016990Medicaid
PA457831OtherBLUE SHIELD
PA0023403000OtherKEYSTONE HEALTHPLAN EAST
PA1016990Medicaid