Provider Demographics
NPI:1114960770
Name:WINTON, BARRY L (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:L
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 1:6006 49TH ST N
Mailing Address - Street 2:STE 310
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2148
Mailing Address - Country:US
Mailing Address - Phone:727-490-5040
Mailing Address - Fax:727-490-5045
Practice Address - Street 1:1345 W BAY DR
Practice Address - Street 2:STE 304
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-2282
Practice Address - Country:US
Practice Address - Phone:727-490-5040
Practice Address - Fax:727-490-5045
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8074208600000X
FLME108817208G00000X
ND11659208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1114960770Medicaid
FL003098800Medicaid
FLP01364510OtherRR MEDICARE
ND15284Medicaid
FL003098800Medicaid
ND15284Medicaid
NDN715308Medicare PIN
FLEM192YMedicare PIN
FL0471260001Medicare NSC