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General NPI Number Information
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NPI Number | 1205397940
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA REPRODUCTIVE MEDICINE, LLC
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 03/26/2019
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Provider Practice Location Address
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Address Line | 836 PRUDENTIAL DRIVE SUITE 902
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City | JACKSONVILLE
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State | FL
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Zip | 32207
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Country | US
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Telephone | 904-281-9887
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Fax | 904-281-9985
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Provider Business Mailing Address
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Address Line | 14540 OLD ST. AUGUSTINE ROAD SUITE 2503
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City | JACKSONVILLE
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State | FL
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Zip | 32258
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Country | US
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Telephone | 904-281-9887
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Fax | 904-281-9985
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEVIN WINSLOW
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Credential | M.D.
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Telephone | 904-399-5620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number |
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License Number State |
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