Healthcare Provider Details

I. General information

NPI: 1861461014
Provider Name (Legal Business Name): DAVID BARRON WINKLES R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3818 HIGHWAY 90
PACE FL
32571-1014
US

IV. Provider business mailing address

5901 COUNTRY CLUB ROAD
MILTON FL
32570
US

V. Phone/Fax

Practice location:
  • Phone: 850-994-7005
  • Fax: 850-994-6996
Mailing address:
  • Phone: 820-626-1569
  • Fax: 850-994-6996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS0017047
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: