Provider Demographics
NPI:1427253053
Name:DR. AMANDA WEISS & ASSOCIATES P.A.
Entity type:Organization
Organization Name:DR. AMANDA WEISS & ASSOCIATES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-876-5385
Mailing Address - Street 1:272 CLOCKTOWER DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3503
Mailing Address - Country:US
Mailing Address - Phone:561-876-5385
Mailing Address - Fax:
Practice Address - Street 1:1715 S FEDERAL HWY STE C1
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-3329
Practice Address - Country:US
Practice Address - Phone:561-276-5099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4077152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty