Provider Demographics
NPI:1750396206
Name:RONALD D. SMITH & EDUARDO WEISS MD PA
Entity type:Organization
Organization Name:RONALD D. SMITH & EDUARDO WEISS MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-961-1200
Mailing Address - Street 1:3850 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6748
Mailing Address - Country:US
Mailing Address - Phone:954-961-1200
Mailing Address - Fax:954-963-0378
Practice Address - Street 1:3000 SW 148TH AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4169
Practice Address - Country:US
Practice Address - Phone:954-885-5551
Practice Address - Fax:954-885-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0028Medicare ID - Type UnspecifiedPROVIDER NUMBER