Organization
VINYARD INSTITUTE OF PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM J WINYARD MD (OWNER)
(913) 244-7254
Entity
Organization
Contact information
Practice address
291 NW PEACOCK BLVD STE 104, PORT ST LUCIE, FL 34986-2214
(913) 244-7254
Mailing address
151 MANOR CIR, JUPITER, FL 33458-1642
(913) 244-7254
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME120069
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME120069
MEDICAL LICENSE
FL
Enumeration date
06/21/2018
Last updated
06/21/2018
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