Provider Demographics
NPI:1427011451
Name:WINTON, LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:WINTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:MANAGED CARE DEPT
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:21150 BISCAYNE BLVD
Practice Address - Street 2:404
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1226
Practice Address - Country:US
Practice Address - Phone:305-466-9111
Practice Address - Fax:305-466-9127
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME10402174400000X
FLME0010402208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1193520OtherWELLCARE
FL047513100Medicaid
FLP0003169OtherFLORIDA HEALTHCARE PLUS
FL4068077OtherAETNA PROVIDER #
FLP00721040OtherRAILROAD MEDICARE
FL90635OtherBCBS FL
FLWELLCAREOther1193520
FL1193520OtherWELLCARE
FL21199FMedicare PIN
FLP00721040OtherRAILROAD MEDICARE
FL047513100Medicaid