Individual
WINIFRIED MCCALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1104 BARTOW RD # H85, LAKELAND, FL 33801-5850
(863) 812-7724
Mailing address
1104 BARTOW RD # H85, LAKELAND, FL 33801-5850
(863) 812-7724
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
102424
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010465800
—
FL
Enumeration date
03/29/2016
Last updated
03/29/2016
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