Provider Demographics
NPI:1396038410
Name:BRETT E WEINSTEIN P A
Entity Type:Organization
Organization Name:BRETT E WEINSTEIN P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:954-742-5265
Mailing Address - Street 1:7195 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-1050
Mailing Address - Country:US
Mailing Address - Phone:954-742-5265
Mailing Address - Fax:954-749-3197
Practice Address - Street 1:7195 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-1050
Practice Address - Country:US
Practice Address - Phone:954-742-5265
Practice Address - Fax:954-749-3197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-23
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006506111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22831OtherPTAN
FL380394500Medicaid
FLU38929Medicare UPIN