Provider Demographics
NPI:1720401318
Name:WIN, MYO S (MD)
Entity Type:Individual
Prefix:
First Name:MYO
Middle Name:S
Last Name:WIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 746638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6638
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:8614 BAYMEADOWS WAY STE 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-8236
Practice Address - Country:US
Practice Address - Phone:904-396-0450
Practice Address - Fax:904-346-0212
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2022-07-28
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Provider Licenses
StateLicense IDTaxonomies
FLME150276207R00000X
NY285727207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine