Provider Demographics
NPI:1508848201
Name:WINSLOW, KEVIN L (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:L
Last Name:WINSLOW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:836 PRUDENTIAL DR
Mailing Address - Street 2:SUITE 902
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8334
Mailing Address - Country:US
Mailing Address - Phone:904-399-5620
Mailing Address - Fax:904-399-8816
Practice Address - Street 1:836 PRUDENTIAL DR
Practice Address - Street 2:SUITE 902
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8334
Practice Address - Country:US
Practice Address - Phone:904-399-5620
Practice Address - Fax:904-399-8816
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL47697207VE0102X
GA048401207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD20920Medicare UPIN