Provider Demographics
NPI:1730273210
Name:WEIRICH, STEPHEN ARTHUR (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ARTHUR
Last Name:WEIRICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11645 BISCAYNE BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3138
Mailing Address - Country:US
Mailing Address - Phone:305-538-8835
Mailing Address - Fax:305-938-4044
Practice Address - Street 1:1221 71ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3647
Practice Address - Country:US
Practice Address - Phone:305-538-8835
Practice Address - Fax:305-865-1881
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME101487207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000527500Medicaid
FL000527500Medicaid
FL000527500Medicaid