Provider Demographics
NPI:1255662581
Name:WINN, SAMUEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:M
Last Name:WINN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2740 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-4826
Mailing Address - Country:US
Mailing Address - Phone:954-925-2740
Mailing Address - Fax:954-927-1941
Practice Address - Street 1:2740 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-4826
Practice Address - Country:US
Practice Address - Phone:954-925-2740
Practice Address - Fax:954-927-1941
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME11886207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL06883OtherMEDICARE
FL050337100Medicaid
FLAW2002070OtherDEA
FLD51757Medicare UPIN