Provider Demographics
NPI:1124079983
Name:WEISS, EDWARD (OD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:WEISS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9844 BIRD RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3912
Mailing Address - Country:US
Mailing Address - Phone:305-221-3322
Mailing Address - Fax:
Practice Address - Street 1:9844 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3912
Practice Address - Country:US
Practice Address - Phone:305-221-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 2220152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
53682OtherDAVIS VISION
41297OtherAVESIS
EW15887OtherUNITED HEALTH CARE
650432986OtherNATIONAL VISION ADMINISTR
FL2220OtherEYEMED
19560OtherBC BS OF FLORIDA
OPC-2220OtherVISION BENEFITS OF AMERIC
EW15887OtherUNITED HEALTH CARE
OPC-2220OtherVISION BENEFITS OF AMERIC