Provider Demographics
NPI:1164017232
Name:PRESY, WINDY
Entity Type:Individual
Prefix:
First Name:WINDY
Middle Name:
Last Name:PRESY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23515 VALDERAMA LN
Mailing Address - Street 2:
Mailing Address - City:SORRENTO
Mailing Address - State:FL
Mailing Address - Zip Code:32776-6937
Mailing Address - Country:US
Mailing Address - Phone:386-538-3333
Mailing Address - Fax:
Practice Address - Street 1:23515 VALDERAMA LN
Practice Address - Street 2:
Practice Address - City:SORRENTO
Practice Address - State:FL
Practice Address - Zip Code:32776-6937
Practice Address - Country:US
Practice Address - Phone:386-538-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21-157487106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician