Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | CH 3935 | FL |
NPI | 1558724583 |
---|---|
Provider Name | Dr. Michael Weinreb |
First Address | Aventura, FL 33180 |
Second Address | Aventura, FL 33180-2566 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2016 |
Last Update Date | 29/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CH 3935 | STATE LICENSE NUMBER (01) | FL |