Healthcare Provider Details

I. General information

NPI: 1821501982
Provider Name (Legal Business Name): WINONA LOUISE WERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2017
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7025 N HIGHWAY 1
COCOA FL
32927-5092
US

IV. Provider business mailing address

1541 SE 17TH ST
OCALA FL
34471-4607
US

V. Phone/Fax

Practice location:
  • Phone: 321-633-3278
  • Fax:
Mailing address:
  • Phone: 352-732-5590
  • Fax: 352-732-0292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberARNP9349987
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: