Provider Demographics
NPI:1760487177
Name:WEINREB, NEAL J (MD)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:J
Last Name:WEINREB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 ROYAL PALM BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5701
Mailing Address - Country:US
Mailing Address - Phone:954-755-1904
Mailing Address - Fax:954-755-1910
Practice Address - Street 1:8170 ROYAL PALM BLVD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5701
Practice Address - Country:US
Practice Address - Phone:954-755-1904
Practice Address - Fax:954-755-1904
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0026615174400000X
FLME26615207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057877100Medicaid
FL93311WMedicare PIN
FL057877100Medicaid