Provider Demographics
NPI:1205588324
Name:ANSIBLE PROFESSIONALS LLC
Entity type:Organization
Organization Name:ANSIBLE PROFESSIONALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WINIARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:877-267-4253
Mailing Address - Street 1:249 CENTRAL PARK AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3271
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:249 CENTRAL PARK AVE STE 300
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3271
Practice Address - Country:US
Practice Address - Phone:877-267-4253
Practice Address - Fax:877-395-9003
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANSIBLEHEALTH INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-20
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty