Provider Demographics
NPI:1124297296
Name:WINTERS, WILLIAM C (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:WINTERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 290065
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-0065
Mailing Address - Country:US
Mailing Address - Phone:386-761-1111
Mailing Address - Fax:386-304-3403
Practice Address - Street 1:719 BEVILLE RD
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-1823
Practice Address - Country:US
Practice Address - Phone:386-761-1112
Practice Address - Fax:368-304-3403
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 569672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75722AMedicare PIN