| Jack R Weitz Phd Pa | |
|
1021 Ives Dairy Rd Bldg 3 Suite 119 N Miami Beach FL 33179 | |
| (305) 655-2335 | |
| (305) 652-5759 |
| Full Name | Jack R Weitz Phd Pa |
|---|---|
| Speciality | Psychologist |
| Location | 1021 Ives Dairy Rd, N Miami Beach, Florida |
| Authorized Official Name and Position | Jack Robert Weitz (PRESIDENT PSYCHOLOGIST) |
| Authorized Official Contact | 3056552335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack R Weitz Phd Pa 1021 Ives Dairy Rd Bldg 3 Suite 119 N Miami Beach FL 33179 Ph: (305) 655-2335 | Jack R Weitz Phd Pa 1021 Ives Dairy Rd Bldg 3 Suite 119 N Miami Beach FL 33179 Ph: (305) 655-2335 |
| NPI Number | 1063579662 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5799968640 |
|---|---|
| Medicare Enrollment ID | O20110330000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063579662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY4345 (Florida) | Primary |
| Provider Name | Jack R Weitz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407904873 PECOS PAC ID: 8123201076 Enrollment ID: I20110330000878 |
Chrysalis Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1868 Ne 164th St, N Miami Beach, FL 33162 Phone: 954-587-1008 |