Individual provider Active NPI

Mark David Weisman, RPH

  • Pharmacist
  • Clermont, FL
National Provider Identifier
1417068610
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS0026101 Issued in FL
Practice address
684 E Highway 50
Clermont, FL 34711-3184
Phone
(352) 242-9061
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS0026101 FL Primary

Addresses

Primary practice location

684 E Highway 50
Clermont, FL 34711-3184

Mailing address

2749 Valiant Dr
Clermont, FL 34711-5248
Phone (352) 241-8920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS0026101FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417068610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2749 VALIANT DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347115248",
            "telephone_number": "352-241-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 E HIGHWAY 50",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347113184",
            "telephone_number": "352-242-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISMAN",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS0026101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.