Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | FL1904 | FL |
NPI | 1003922840 |
---|---|
Provider Name | Brett M Weintraub |
First Address | Lauderdale Lakes, FL 33313-1910 |
Second Address | Lauderdale Lakes, FL 33313-1910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 08/07/2007 |