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Individual

LEE WINANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1700 S 23RD ST, FORT PIERCE, FL 34950-4803
(772) 468-4551
Mailing address
1700 S 23RD ST, FORT PIERCE, FL 34950-4803

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
55999
GA
207P00000X
Emergency Medicine Physician
Primary
ME98688
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
316643965A
GA
01
967530
BLUE CROSS BLUE SHIELD
GA
05
G55999
SC
01
P00237267
RAILROAD
GA
Enumeration date
05/17/2006
Last updated
03/07/2023
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