Individual
DR. MITCHELL B WEISBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 BEVILLE RD STE 105, DAYTONA BEACH, FL 32114-5644
(386) 213-4148
(386) 213-4153
Mailing address
1500 BEVILLE RD, DAYTONA BEACH, FL 32114-5646
(386) 213-4148
(386) 213-4153
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME63365
FL
207RH0003X
Hematology & Oncology Physician
Primary
ME63365
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10612327
CIGNA
FL
01
—
18673
BC/BS OF FL
FL
01
—
375700500
MEDICAID SECONDARY
FL
01
—
5767330
AETNA
FL
01
—
650879131
UNITED HEALTH CARE
FL
Enumeration date
11/09/2005
Last updated
12/09/2019
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