Provider Demographics
NPI:1861461014
Name:WINKLES, DAVID BARRON (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BARRON
Last Name:WINKLES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 COUNTRY CLUB ROAD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570
Mailing Address - Country:US
Mailing Address - Phone:820-626-1569
Mailing Address - Fax:850-994-6996
Practice Address - Street 1:3818 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-1014
Practice Address - Country:US
Practice Address - Phone:850-994-7005
Practice Address - Fax:850-994-6996
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0017047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist