Provider Demographics
NPI:1871891937
Name:WEINSTEIN, JILL ANN (RPH)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ANN
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 MAITLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5432
Mailing Address - Country:US
Mailing Address - Phone:407-260-7002
Mailing Address - Fax:407-260-7044
Practice Address - Street 1:393 MAITLAND AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5432
Practice Address - Country:US
Practice Address - Phone:407-260-7002
Practice Address - Fax:407-260-7044
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS00223841835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist