MEDICARE: TERRELL P WINKLER MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194870030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TERRELL P WINKLER MD PA

Provider Business Mailing Address
First Line	:	4001 NORTH OCEAN DRIVE
Second Line	:	SUITE 203
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5968
Country	:	US
Telephone Number	:	954-491-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 NORTH OCEAN DRIVE
Second Line	:	SUITE 203
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5968
Country	:	US
Telephone Number	:	954-491-5511
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TERRELL P WINKLER
Credential	:	MD
Telephone Number	:	954-491-5511

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	08/22/2020

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