Healthcare Provider Details

I. General information

NPI: 1174623417
Provider Name (Legal Business Name): CHRISTOPHER WINTERBOTTOM RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E SILVER SPRINGS BLVD SUITE 213
OCALA FL
34470-6831
US

IV. Provider business mailing address

1515 E SILVER SPRINGS BLVD SUITE 213
OCALA FL
34470-6831
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-2100
  • Fax:
Mailing address:
  • Phone: 352-369-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN9243437
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number305449
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: