Provider Demographics
NPI:1164833489
Name:LAU-SWISHER, WINCIE ROSE (MD)
Entity Type:Individual
Prefix:
First Name:WINCIE
Middle Name:ROSE
Last Name:LAU-SWISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:670 GLADES ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6424
Mailing Address - Country:US
Mailing Address - Phone:561-955-2570
Mailing Address - Fax:561-955-2572
Practice Address - Street 1:670 GLADES RD
Practice Address - Street 2:SUITE 400
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6461
Practice Address - Country:US
Practice Address - Phone:561-955-2570
Practice Address - Fax:561-955-2572
Is Sole Proprietor?:No
Enumeration Date:2014-05-09
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLTRN # 19885207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine