Provider Demographics
NPI:1538517792
Name:WEINBERG, JULIE RAE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:RAE
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:303 N CLYDE MORRIS BLVD
Mailing Address - Street 2:EMERGENCY MEDICINE
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-0001
Mailing Address - Country:US
Mailing Address - Phone:386-425-2285
Mailing Address - Fax:386-425-7522
Practice Address - Street 1:10E PBFS
Practice Address - Street 2:303 N CLYDE MORRIS BLVD
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-0001
Practice Address - Country:US
Practice Address - Phone:386-425-2285
Practice Address - Fax:386-425-7522
Is Sole Proprietor?:No
Enumeration Date:2016-05-28
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125.068447208000000X, 390200000X
FLME1419492080P0204X
FLME141767208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104394500Medicaid