Provider Demographics
NPI:1992813125
Name:WEINSTEIN, JAY M (PHD)
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:M
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:1399 NW 17TH AVE
Mailing Address - Street 2:STE 306D
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-2334
Mailing Address - Country:US
Mailing Address - Phone:305-545-1110
Mailing Address - Fax:305-675-0361
Practice Address - Street 1:1399 NW 17TH AVE
Practice Address - Street 2:SUITE 306D
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-545-1110
Practice Address - Fax:305-545-0211
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2016-06-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPY3266103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBJ701ZMedicare PIN