Provider Demographics
NPI:1336294305
Name:DR. PHILIP K WINKLER & ASSOC, P.A.
Entity Type:Organization
Organization Name:DR. PHILIP K WINKLER & ASSOC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:813-684-7071
Mailing Address - Street 1:2416 W BRANDON BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4717
Mailing Address - Country:US
Mailing Address - Phone:813-684-7071
Mailing Address - Fax:
Practice Address - Street 1:2416 W BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4717
Practice Address - Country:US
Practice Address - Phone:813-684-7071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 2001152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33822Medicare ID - Type Unspecified
FLU52893Medicare UPIN