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General NPI Number Information
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NPI Number | 1366220451
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Entity Type | Individual
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Provider Name | CELIA WINES FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 7648 S FLORIDA AVE
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City | FLORAL CITY
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State | FL
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Zip | 34436-2738
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Country | US
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Telephone | 352-726-3700
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Fax | 352-726-8570
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Provider Business Mailing Address
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Address Line | 5425 E ANNA JO DR
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City | INVERNESS
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State | FL
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Zip | 34452-8411
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Country | US
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Telephone | 352-220-0122
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11028718
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License Number State | FL
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