Healthcare Provider Details

I. General information

NPI: 1992725600
Provider Name (Legal Business Name): NATHAN S WINTON R.R.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13194 SPRING LAKE DR
COOPER CITY FL
33330-2664
US

IV. Provider business mailing address

13194 SPRING LAKE DR
COOPER CITY FL
33330-2664
US

V. Phone/Fax

Practice location:
  • Phone: 954-680-2031
  • Fax: 954-252-0690
Mailing address:
  • Phone: 954-680-2031
  • Fax: 954-252-0690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT 3217
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: