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General NPI Number Information
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NPI Number | 1639104177
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Entity Type | Individual
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Provider Name | MAXINE WEINSTEIN PHD
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 6601 SW 80TH ST SUITE 202
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4661
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Country | US
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Telephone | 305-661-5574
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Fax |
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Provider Business Mailing Address
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Address Line | 13860 SW 73RD CT
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City | VILLAGE OF PALMETTO BAY
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State | FL
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Zip | 33158-1214
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Country | US
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Telephone | 305-238-3166
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Fax | 305-251-0533
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY2680
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License Number State | FL
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