Organization
GARY M. WEISS, M.D., P.A.
Active
Other names
Weiss & Newberry Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY M WEISS M.D. (PRESIDENT)
(321) 727-9063
Entity
Organization
Contact information
Practice address
1051 PORT MALABAR BLVD NE, SUITE 6, PALM BAY, FL 32905-5153
(321) 727-9063
(321) 728-1955
Mailing address
1051 PORT MALABAR BLVD NE, SUITE 6, PALM BAY, FL 32905-5153
(321) 727-9063
(321) 728-1955
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME 39943
FL
174400000X
Specialist
ME 62341
FL
363L00000X
Nurse Practitioner
2100062
FL
363L00000X
Nurse Practitioner
9168017
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066754400
—
FL
01
—
62367
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/23/2006
Last updated
09/20/2011
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