Provider Demographics
NPI:1619169083
Name:WEINSTOCK, REBECA-ANN (DDS)
Entity Type:Individual
Prefix:
First Name:REBECA-ANN
Middle Name:
Last Name:WEINSTOCK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 PALM SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-7847
Mailing Address - Country:US
Mailing Address - Phone:407-834-6446
Mailing Address - Fax:407-830-4978
Practice Address - Street 1:664 PALM SPRINGS DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-7847
Practice Address - Country:US
Practice Address - Phone:407-834-6446
Practice Address - Fax:407-830-4978
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18105122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist