Individual
DR. FREDERICK ETHAN WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 W PLYMOUTH AVE, DELAND, FL 32720-3236
(386) 943-3160
(317) 705-5047
Mailing address
960 MASSACHUSETTS AVE, FLR 2, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME123132
FL
2085N0700X
Neuroradiology Physician
ME123132
FL
2085R0202X
Diagnostic Radiology Physician
294889
MA
2085R0202X
Diagnostic Radiology Physician
ETL7045
MA
2085R0202X
Diagnostic Radiology Physician
Primary
MD448028
PA
2085R0202X
Diagnostic Radiology Physician
ME155139
FL
208VP0000X
Pain Medicine Physician
294889
MA
208VP0000X
Pain Medicine Physician
ME123132
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110189230A
—
MA
05
—
3137500
—
NH
Enumeration date
05/13/2008
Last updated
02/27/2026
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