Provider Demographics
NPI:1851690358
Name:WINN, PATRICK JOSEPH
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOSEPH
Last Name:WINN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 GARDEN PLZ
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4212
Mailing Address - Country:US
Mailing Address - Phone:407-894-8894
Mailing Address - Fax:407-894-8893
Practice Address - Street 1:718 GARDEN PLZ
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4212
Practice Address - Country:US
Practice Address - Phone:407-894-8894
Practice Address - Fax:407-894-8893
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 5455104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker