MEDICARE: JR WEINSTEIN INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	1312824	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R9895	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1932311842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JR WEINSTEIN INC

Provider Business Mailing Address
First Line	:	4009 SW 30TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-6817
Country	:	US
Telephone Number	:	954-321-9762
Fax Number	:

Provider Business Practice Location Address
First Line	:	4009 SW 30TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33312-6817
Country	:	US
Telephone Number	:	954-321-9762
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEROLD R WEINSTEIN
Credential	:
Telephone Number	:	954-321-9762

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	08/22/2020

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