Provider Demographics
NPI:1396038840
Name:WINIARSKI, CONRAD (DC)
Entity Type:Individual
Prefix:DR
First Name:CONRAD
Middle Name:
Last Name:WINIARSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3102 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6738
Mailing Address - Country:US
Mailing Address - Phone:954-933-3839
Mailing Address - Fax:954-933-3836
Practice Address - Street 1:3102 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-6738
Practice Address - Country:US
Practice Address - Phone:954-933-3839
Practice Address - Fax:954-933-3836
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10244111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor