Provider Demographics
NPI:1811987365
Name:TEH, WINNIE SWEE-ENG (MD)
Entity type:Individual
Prefix:
First Name:WINNIE
Middle Name:SWEE-ENG
Last Name:TEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-361-5631
Mailing Address - Fax:
Practice Address - Street 1:1350 HICKORY ST STE 101
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3224
Practice Address - Country:US
Practice Address - Phone:321-361-5631
Practice Address - Fax:321-676-6434
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93583207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01164226OtherRR MEDICARE
FL16721YOtherHFMG MA
FL273289100Medicaid
FL16721YMedicare PIN