Healthcare Provider Details

I. General information

NPI: 1871405159
Provider Name (Legal Business Name): RICARDO WYNTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7102 IVY CROSSING LN
BOYNTON BEACH FL
33436-9419
US

IV. Provider business mailing address

7102 IVY CROSSING LN 7102 IVY CROSSING LANE
BOYNTON BEACH FL
33436-9419
US

V. Phone/Fax

Practice location:
  • Phone: 561-906-4647
  • Fax:
Mailing address:
  • Phone: 561-906-4647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RICARDO WYNTER
Title or Position: OWNER/MANAGING MEMBER
Credential: PA
Phone: 561-906-4647