Provider Demographics
NPI:1760764823
Name:WEINBERG, CECILIA INES (RPH)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:INES
Last Name:WEINBERG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:INES
Other - Last Name:VERAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:1160 MALABAR RD SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-3256
Mailing Address - Country:US
Mailing Address - Phone:321-956-9626
Mailing Address - Fax:321-956-0795
Practice Address - Street 1:1160 MALABAR RD SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-3256
Practice Address - Country:US
Practice Address - Phone:321-956-9626
Practice Address - Fax:321-956-0795
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS32404183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist