Provider Demographics
NPI:1245220409
Name:WINGER, DOUGLAS G (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:G
Last Name:WINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2400 N ORANGE BLOSSOM TRL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-2306
Mailing Address - Country:US
Mailing Address - Phone:407-846-7200
Mailing Address - Fax:407-846-3989
Practice Address - Street 1:2400 N. ORANGE BLOSSOM TRAIL
Practice Address - Street 2:SUITE 300
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4198
Practice Address - Country:US
Practice Address - Phone:407-846-7200
Practice Address - Fax:407-846-3989
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 0046628207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063481600Medicaid
FL59997ZMedicare ID - Type Unspecified
FLD57093Medicare UPIN