Individual
MRS. ELIZABETH V WEISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2360 MADRID AVE SE, PALM BAY, FL 32909-6427
(321) 956-8141
(321) 768-1220
Mailing address
2360 MADRID AVE SE, PALM BAY, FL 32909-6427
(321) 956-8141
(321) 768-1220
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9646
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001156500
—
FL
Enumeration date
03/06/2013
Last updated
11/02/2023
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