Provider Demographics
NPI:1235134917
Name:ALEXIS, WINSTON LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:WINSTON
Middle Name:LOUIS
Last Name:ALEXIS
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 1:5975 W. SUNRISE BLVD.
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SUNRISW
Mailing Address - State:FL
Mailing Address - Zip Code:33313
Mailing Address - Country:US
Mailing Address - Phone:954-791-4311
Mailing Address - Fax:954-791-2729
Practice Address - Street 1:5975 W. SUNRISE BLVD.
Practice Address - Street 2:SUITE 105
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313
Practice Address - Country:US
Practice Address - Phone:954-791-4311
Practice Address - Fax:954-791-2729
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36984207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269097700Medicaid
FLD63693Medicare UPIN
D63693Medicare UPIN
FL96013YMedicare PIN