Healthcare Provider Details

I. General information

NPI: 1285439216
Provider Name (Legal Business Name): WINSTON POINDEXTER EMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2585 LIBERTY PARK DR APT 8302
CAPE CORAL FL
33909-3703
US

IV. Provider business mailing address

2585 LIBERTY PARK DR APT 8302
CAPE CORAL FL
33909-3703
US

V. Phone/Fax

Practice location:
  • Phone: 603-969-5212
  • Fax:
Mailing address:
  • Phone: 603-969-5212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number584750
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: