Provider Demographics
NPI:1720048036
Name:WEINSTEIN, BRIAN K (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:K
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NW 84TH AVE STE 311
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1859
Mailing Address - Country:US
Mailing Address - Phone:954-476-9899
Mailing Address - Fax:954-476-9180
Practice Address - Street 1:350 NW 84TH AVE
Practice Address - Street 2:#311
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1817
Practice Address - Country:US
Practice Address - Phone:954-476-9899
Practice Address - Fax:954-476-9180
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76600208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL43979OtherBCBS OF FL
FL255093800Medicaid
FL43979XMedicare PIN
FL43979OtherBCBS OF FL
FL255093800Medicaid