Individual
GARY M WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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
2084N0400X
Neurology Physician
Primary
ME39943
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066754400
—
FL
01
—
62367
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/19/2006
Last updated
01/25/2010
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