Provider Demographics
NPI:1861823965
Name:HEFLIN, WINIFRED (RN)
Entity Type:Individual
Prefix:MRS
First Name:WINIFRED
Middle Name:
Last Name:HEFLIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7725 SE 147TH PL
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-4237
Mailing Address - Country:US
Mailing Address - Phone:352-245-5932
Mailing Address - Fax:352-245-6275
Practice Address - Street 1:14660 SE 77TH CT
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-4206
Practice Address - Country:US
Practice Address - Phone:352-245-5932
Practice Address - Fax:352-245-6275
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-29
Last Update Date:2013-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1431942163W00000X
FL00042314163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1431942OtherFLORIDA DEPARTMENT OF HEALTH - REGISTERED NURSING LICENSE