Provider Demographics
NPI:1255672689
Name:S PAUL WINOKUR MD PA
Entity type:Organization
Organization Name:S PAUL WINOKUR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WINOKUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-832-1234
Mailing Address - Street 1:1411 N FLAGLER DR STE 8300
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3413
Mailing Address - Country:US
Mailing Address - Phone:561-832-1234
Mailing Address - Fax:561-832-5316
Practice Address - Street 1:1411 N FLAGLER DR STE 8300
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3413
Practice Address - Country:US
Practice Address - Phone:561-832-1234
Practice Address - Fax:561-832-5316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME24633208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051066100Medicaid
FL051066100Medicaid
73086Medicare PIN