Provider Demographics
NPI:1386455756
Name:WINTER, JACQUELINE P (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:P
Last Name:WINTER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 SW 143RD ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33158-1455
Mailing Address - Country:US
Mailing Address - Phone:786-210-0023
Mailing Address - Fax:
Practice Address - Street 1:8300 SW 143RD ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33158-1455
Practice Address - Country:US
Practice Address - Phone:786-210-0023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty