Provider Demographics
NPI:1386763761
Name:WINFIELD, FAITH NEEMERA (COTA)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:NEEMERA
Last Name:WINFIELD
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11247 SAN JOSE BLVD
Mailing Address - Street 2:806
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-7948
Mailing Address - Country:US
Mailing Address - Phone:904-527-1623
Mailing Address - Fax:
Practice Address - Street 1:2802 PARENTAL HOME RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-5702
Practice Address - Country:US
Practice Address - Phone:904-721-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10134224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant