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Individual

DR. WINSTON E EVALLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3351 WEDGEWOOD LN, THE VILLAGES, FL 32162-7181
(352) 259-0364
(352) 259-2174
Mailing address
3351 WEDGEWOOD LN, THE VILLAGES, FL 32162-7181
(352) 259-0364
(352) 259-2174

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME80483
FL
207R00000X
Internal Medicine Physician
ME80483
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME80483
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
259469200
FL
01
58634
BC/BS
FL
01
P00061439
RR MEDICARE
FL
Enumeration date
08/11/2006
Last updated
12/13/2013
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