Provider Demographics
NPI:1982263703
Name:WINNER, SYDNEY BROOKE
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:BROOKE
Last Name:WINNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6530 CIRCLE ROCK WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-8954
Mailing Address - Country:US
Mailing Address - Phone:954-790-4811
Mailing Address - Fax:
Practice Address - Street 1:6530 CIRCLE ROCK WAY
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-8954
Practice Address - Country:US
Practice Address - Phone:954-790-4811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA18262235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33882OtherCALIFORNIA SPEECH PATHOLOGIST
FLSA18262OtherFLORIDA SPEECH LANGUAGE PATHOLOGIST LICENSE
CA33882OtherCALIFORNIA SPEECH PATHOLOGIST