Provider Demographics
NPI:1225298730
Name:WINN, SHENIKA DAKIA (LMT)
Entity Type:Individual
Prefix:MS
First Name:SHENIKA
Middle Name:DAKIA
Last Name:WINN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 SE MIMOSA ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-8549
Mailing Address - Country:US
Mailing Address - Phone:772-324-0949
Mailing Address - Fax:
Practice Address - Street 1:9002 SE BRIDGE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-5324
Practice Address - Country:US
Practice Address - Phone:772-324-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA39875174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist