Organization
CICATRIX OF WINTER PARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY PAUL EWBANK (OWNER)
(407) 449-2645
Entity
Organization
Contact information
Practice address
1270 ORANGE AVE STE D1, WINTER PARK, FL 32789-4946
(407) 587-5559
Mailing address
1270 ORANGE AVE STE D1, WINTER PARK, FL 32789-4946
(407) 587-5559
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
09/11/2025
Last updated
09/11/2025
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