Provider Demographics
NPI:1508911298
Name:WIN, ROLAND BA (MD)
Entity Type:Individual
Prefix:
First Name:ROLAND
Middle Name:BA
Last Name:WIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18167 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 285
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3528
Mailing Address - Country:US
Mailing Address - Phone:727-507-3606
Mailing Address - Fax:727-507-3630
Practice Address - Street 1:3231 N MCMULLEN BOOTH RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2045
Practice Address - Country:US
Practice Address - Phone:727-725-6100
Practice Address - Fax:727-725-6118
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2011-04-28
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Provider Licenses
StateLicense IDTaxonomies
FLME41121207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D67365Medicare UPIN