Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 1915142 | FL |
NPI | 1003051095 |
---|---|
Provider Name | Dr. Jodi Karen Weissman |
First Address | Boca Raton, FL 33433 |
Second Address | Boca Raton, FL 33431-4154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2008 |
Last Update Date | 28/07/2021 |