MEDICARE: DR. HARRY DAVID WEINSTEIN OD

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	152W00000X	Optometrist	OPC 2137	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568540870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY DAVID WEINSTEIN OD

Provider Business Mailing Address
First Line	:	PO BOX 57784
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32241-7784
Country	:	US
Telephone Number	:	904-272-9433
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 STATE ROAD 13
Second Line	:
City	:	SAINT JOHNS
State	:	FL
Zip	:	32259-3860
Country	:	US
Telephone Number	:	904-287-3678
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	03/17/2018

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