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General NPI Number Information
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NPI Number | 1700191863
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Entity Type | Organization
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Legal Business Name | LORRAINE WINCOR P.A.
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 08/13/2010
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Provider Practice Location Address
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Address Line | 3200 PORT ROYALE DR # 1203
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City | FT. LAUDERDALE
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State | FL
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Zip | 33308-7805
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Country | US
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Telephone | 954-772-6015
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Fax | 954-772-6099
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Provider Business Mailing Address
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Address Line | 3200 PORT ROYALE DR. # 1203
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City | FT. LAUDERDALE
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State | FL
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Zip | 33308-7805
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Country | US
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Telephone | 954-772-6015
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Fax | 954-772-6099
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Authorized Official
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Title or Position | DR.
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Name | DR. LORRAINE WINCOR
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Credential | PSYD.
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Telephone | 954-772-6015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0003464
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License Number State | FL
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