Healthcare Provider Details

I. General information

NPI: 1952840993
Provider Name (Legal Business Name): MRS. MEGAN ROTH WINK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN MARY ROTH CRNA

II. Dates (important events)

Enumeration Date: 02/22/2017
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 SOUTH CONGRESS AVENUE JFK MEDICAL CENTER
ATLANTIS FL
33462
US

IV. Provider business mailing address

165 ATWELL DR
WEST PALM BEACH FL
33411-4609
US

V. Phone/Fax

Practice location:
  • Phone: 561-965-7300
  • Fax:
Mailing address:
  • Phone: 561-379-7037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9265466
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: