MEDICARE: MARC K WEINBERG DC 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	111N00000X	Chiropractor	CH6619	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	:	1790084911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARC K WEINBERG DC PA

Provider Business Mailing Address
First Line	:	1352 NE 163ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4623
Country	:	US
Telephone Number	:	305-949-5999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1352 NE 163RD ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4623
Country	:	US
Telephone Number	:	305-949-5999
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARC KEVIN WEINBERG
Credential	:	DC
Telephone Number	:	305-949-5999

Provider Enumeration Date	:	03/28/2011
Last Update Date	:	03/28/2011

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