Provider Demographics
NPI:1952499493
Name:WEINSTEIN, GARRETT ROSS (DC)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:ROSS
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10865 BLUE PALM ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-8233
Mailing Address - Country:US
Mailing Address - Phone:954-772-2711
Mailing Address - Fax:954-491-4956
Practice Address - Street 1:919 NE 62ND ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-4116
Practice Address - Country:US
Practice Address - Phone:954-772-2711
Practice Address - Fax:954-491-4956
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53853OtherBLUE CROSS BLUE SHIELD