Provider Demographics
NPI:1568649952
Name:WINKLER, BRIAN DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DANIEL
Last Name:WINKLER
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 1:11915 BEACH BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-6704
Mailing Address - Country:US
Mailing Address - Phone:904-683-0793
Mailing Address - Fax:904-619-4740
Practice Address - Street 1:11915 BEACH BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-6704
Practice Address - Country:US
Practice Address - Phone:904-683-0793
Practice Address - Fax:904-619-4740
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor