10D2042969 CLIA NUMBER - GARY M WEISS MD PA

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Laboratory Demographics

CLIA Number: 10D2042969

Facility Name: GARY M WEISS MD PA

Facility Address:
1051 PORT MALABAR BLVD NE STE 6
PALM BAY, FL
ZIP 32905
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Facility Phone Number: 321 727-9063

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1710967328

Taxonomy: 2084N0400X - Psychiatry & Neurology
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

CLIA Record

Field Name	Field Value
CLIA Number	10D2042969
LAB Type	Physician Office
Facility Name	GARY M WEISS MD PA
Street	1051 PORT MALABAR BLVD NE STE 6
City	PALM BAY
State	FL
ZIP	32905
Phone	321 727-9063
CertificateType	4
CertificateEffectiveDate	6/25/2022
CertificateExpirationDate	6/24/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024