MEDICARE: ANDREW WEINSTEIN MD PA

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	207RC0000X	Cardiovascular Disease Physician	ME58373	FL

General Provider Information

NPI Number	:	1770650400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREW WEINSTEIN MD PA

Provider Business Mailing Address
First Line	:	2563 OAK ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4559
Country	:	US
Telephone Number	:	904-388-3666
Fax Number	:	904-389-3334

Provider Business Practice Location Address
First Line	:	2563 OAK ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4559
Country	:	US
Telephone Number	:	904-388-3666
Fax Number	:	904-389-3334

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDREW J. WEINSTEIN
Credential	:	MD
Telephone Number	:	904-388-3666

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	08/22/2020

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