MEDICARE: MR. CHRISTOPHER WINTERBOTTOM RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0400X	Case Management Registered Nurse	RN9243437	FL
2	163W00000X	Registered Nurse	305449	NY

General Provider Information

NPI Number	:	1174623417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER WINTERBOTTOM RN

Provider Business Mailing Address
First Line	:	1515 E SILVER SPRINGS BLVD
Second Line	:	SUITE 213
City	:	OCALA
State	:	FL
Zip	:	34470-6831
Country	:	US
Telephone Number	:	352-369-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 E SILVER SPRINGS BLVD
Second Line	:	SUITE 213
City	:	OCALA
State	:	FL
Zip	:	34470-6831
Country	:	US
Telephone Number	:	352-369-2100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	05/13/2008

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