Provider Demographics
NPI:1891888558
Name:WINDMOOR HEALTHCARE INC
Entity Type:Organization
Organization Name:WINDMOOR HEALTHCARE INC
Other - Org Name:WINDMOOR HEALTHCARE OF CLEARWATER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SRVP CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3300
Mailing Address - Street 1:11300 US 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-7451
Mailing Address - Country:US
Mailing Address - Phone:727-541-2646
Mailing Address - Fax:727-541-4402
Practice Address - Street 1:11300 US 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-7451
Practice Address - Country:US
Practice Address - Phone:727-541-2646
Practice Address - Fax:727-541-4402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
FL4037283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes283Q00000XHospitalsPsychiatric Hospital
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE 84OtherBLUE CROSS BLUE SHIELD
104017Medicare Oscar/Certification