Jack R Weitz PHD PA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY4345 Issued in FL

Legal business name

JACK R WEITZ PHD PA

Practice address

1021 Ives Dairy Rd
BLDG 3 Suite 119
N Miami Beach, FL 33179

Phone

(305) 655-2335

Fax

(305) 652-5759

NPI assigned

Jan 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jack Robert Weitz, PHDNPI 1407904873

Title

President Psychologist

Phone

(305) 655-2335

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jack Robert Weitz, PHD

  • Psychologist
  • North Miami Beach, FL
  • NPI 1407904873
  Medicare reassignment NPD Authorized official
• Nicola Marie Chung, PH.D.

  • Clinical Psychologist
  • North Miami Beach, FL
  • NPI 1003856121
  NPD (past)
• Mitchell Gordon, PH.D., ABPP

  • Psychologist
  • Jacksonville, FL
  • NPI 1669696365
  NPD (past)
• Martin S Laser, MSW

  • Clinical Social Worker
  • Plantation, FL
  • NPI 1114218898
  NPD (past)
• Elizabeth Trop-Roberts, PSY.D.

  • Psychologist
  • Miami, FL
  • NPI 1205256419
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063579662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 IVES DAIRY RD",
            "address_2": "BLDG 3 SUITE 119",
            "city": "N MIAMI BEACH",
            "state": "FL",
            "postal_code": "33179",
            "telephone_number": "305-655-2335",
            "fax_number": "305-652-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 IVES DAIRY RD",
            "address_2": "BLDG 3 SUITE 119",
            "city": "N MIAMI BEACH",
            "state": "FL",
            "postal_code": "33179",
            "telephone_number": "305-655-2335",
            "fax_number": "305-652-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK R WEITZ PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEITZ",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT PSYCHOLOGIST",
        "authorized_official_telephone_number": "305-655-2335",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY4345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yuliet Hernandez, RBT
• Independent Home Care Inc
• Inner-G-Healing 360 Inc.
• Interventional Rehabilitation of South Florida, Inc
• Fabiana Helena Izquierdo, M.D.
• Rafah Midani Jaraki, MD
• Jems Therapy Center Inc
• Jose L Avila MD PA
• Kajaal Medical Services Inc
• Sheldon E Kalmutz, M.D.

• Psychologist in N Miami Beach, FL
• Providers in N Miami Beach, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.