Provider Demographics
NPI:1013068527
Name:ROBERT K WINEGAR PSY D
Entity Type:Organization
Organization Name:ROBERT K WINEGAR PSY D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:WINEGAR
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:941-953-4313
Mailing Address - Street 1:1991 HYDE PARK ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3600
Mailing Address - Country:US
Mailing Address - Phone:941-953-4313
Mailing Address - Fax:941-954-8631
Practice Address - Street 1:1991 HYDE PARK ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3600
Practice Address - Country:US
Practice Address - Phone:941-953-4313
Practice Address - Fax:941-954-8631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-13
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6215103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty