Provider Demographics
NPI:1972829091
Name:WINN, ELEANOR RITA (AS, BC-HIS,ACA)
Entity Type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:RITA
Last Name:WINN
Suffix:
Gender:F
Credentials:AS, BC-HIS,ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16450 SAN CARLOS BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-3271
Mailing Address - Country:US
Mailing Address - Phone:239-415-0727
Mailing Address - Fax:
Practice Address - Street 1:16450 SAN CARLOS BLVD STE 3
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3271
Practice Address - Country:US
Practice Address - Phone:239-415-0727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2687237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist