Provider Demographics
NPI:1366697062
Name:WEISMAN, GILBERT (DO)
Entity type:Individual
Prefix:
First Name:GILBERT
Middle Name:
Last Name:WEISMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 PORTO VECCHIO WAY
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6223
Mailing Address - Country:US
Mailing Address - Phone:561-630-9945
Mailing Address - Fax:425-940-4803
Practice Address - Street 1:134 PORTO VECCHIO WAY
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-6223
Practice Address - Country:US
Practice Address - Phone:561-630-9945
Practice Address - Fax:425-940-4803
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0002452207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine