Provider Demographics
NPI:1093469199
Name:WEINTRAUB, PHILIP (BCC, MA)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:WEINTRAUB
Suffix:
Gender:M
Credentials:BCC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C.W. BILL YOUNG VA MEDICAL CENTER
Mailing Address - Street 2:10000 BAY PINES BLVD
Mailing Address - City:BAY PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33744-8200
Mailing Address - Country:US
Mailing Address - Phone:727-398-6661
Mailing Address - Fax:
Practice Address - Street 1:C.W. BILL YOUNG VA MEDICAL CENTER
Practice Address - Street 2:10000 BAY PINES BLVD
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744-8200
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral