Provider Demographics
NPI:1437330578
Name:WESTON, ERIN (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:WESTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:
Practice Address - Street 1:698 YAMATO RD
Practice Address - Street 2:SUITE 3
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4401
Practice Address - Country:US
Practice Address - Phone:561-912-3211
Practice Address - Fax:561-912-3212
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4252152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL407ZMedicare PIN