Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A71367 | CA |
Y | 207X00000X | Orthopaedic Surgeon | ME104071 | FL |
NPI | 1003817693 |
---|---|
Provider Name | Jason Scott Weisstein |
First Address | West Palm Beach, FL 33407-2413 |
Second Address | West Palm Beach, FL 33407-2413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 14/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A71367 | CA MEDICAL BOARD (01) | CA |
FG825Z | MEDICARE PTAN (01) | CA |
H88470 | (02) | AZ |