Healthcare Provider Details

I. General information

NPI: 1538100771
Provider Name (Legal Business Name): FRANCIS AUGUSTINE WINTER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 FIVAY RD
HUDSON FL
34667-7103
US

IV. Provider business mailing address

10222 OASIS PALM DR
TAMPA FL
33615-2782
US

V. Phone/Fax

Practice location:
  • Phone: 727-819-2929
  • Fax:
Mailing address:
  • Phone: 727-417-3226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9102802
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: