Individual
KIMBERLY LANE WINFREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
678 NARRAGANSETT ST NE, PALM BAY, FL 32907
(321) 634-2196
Mailing address
814 N MAIN ST, KISSIMMEE, FL 34744-5433
(407) 931-1014
(407) 933-1224
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT10919
FL
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891141000
—
FL
Enumeration date
09/29/2010
Last updated
08/03/2023
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