Healthcare Provider Details

I. General information

NPI: 1003051095
Provider Name (Legal Business Name): JODI KAREN WEINSTEIN A.R.N.P, C.S, PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JODI KAREN WEINSTEIN

II. Dates (important events)

Enumeration Date: 12/05/2008
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 NW 2ND AVE STE 101102
BOCA RATON FL
33431-4154
US

IV. Provider business mailing address

7301 W. PALMETTO PARK SUITE 203-A
BOCA RATON FL
33433
US

V. Phone/Fax

Practice location:
  • Phone: 561-563-6262
  • Fax: 561-223-2974
Mailing address:
  • Phone: 561-391-2770
  • Fax: 561-391-2930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License Number023477102
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1915142
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: