Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME49194 | FL |
NPI | 1073629234 |
---|---|
Provider Name | Mr. Thomas F Winters JR. |
First Address | Orlando, FL 32856-1027 |
Second Address | Orlando, FL 32806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 09/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B87170 | (02) |