Provider Demographics
NPI:1568540870
Name:WEINSTEIN, HARRY DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:DAVID
Last Name:WEINSTEIN
Suffix:
Gender:M
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:PO BOX 57784
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32241-7784
Mailing Address - Country:US
Mailing Address - Phone:904-272-9433
Mailing Address - Fax:
Practice Address - Street 1:450 STATE ROAD 13
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-3860
Practice Address - Country:US
Practice Address - Phone:904-287-3678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 2137152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist