Individual
MARK B WEITZENFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21110 BISCAYNE BLVD, SUITE 401, AVENTURA, FL 33180-1227
(305) 933-1772
(305) 675-2788
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME27164
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002364
NHP
FL
01
—
0366037
CIGNA
FL
05
—
040323700
—
FL
01
—
1005619
CAREPLUS
FL
01
—
1256832
WELLCARE MEDICARE ONLY
FL
01
—
203827
AVMED
FL
01
—
2364
DIMENSION
FL
01
—
4200786
AETNA
FL
01
—
56089
BLUE CROSS BLUE SHIELD
FL
01
—
P0001582
SIMPLY
FL
01
—
P00284474
RAILROAD MEDICARE
FL
01
—
P01609935
RR MEDICARE
FL
01
—
P1035626
FREEDOM
FL
01
—
P971396
OPTIMUM
FL
Enumeration date
09/14/2007
Last updated
06/06/2017
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