Individual
MR. BRIAN ROBERT WINGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
640 BREVARD AVE STE 104, COCOA, FL 32922-7849
(321) 433-1111
(321) 252-0425
Mailing address
640 BREVARD AVE STE 104, COCOA, FL 32922-7849
(321) 433-1111
(321) 252-0425
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
225200000X
Physical Therapy Assistant
A3367
MD
Other
Enumeration date
04/02/2009
Last updated
03/01/2021
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