1255054821 NPI number — MRS. JULIE ALYN WINTER RN, IBCLC

Table of content: MRS. JULIE ALYN WINTER RN, IBCLC (NPI 1255054821)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255054821 NPI number — MRS. JULIE ALYN WINTER RN, IBCLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WINTER
Provider First Name:
JULIE
Provider Middle Name:
ALYN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, IBCLC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255054821
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15502 STONEYBROOK WEST PKWY
Provider Second Line Business Mailing Address:
STE 104
Provider Business Mailing Address City Name:
WINTER GARDEN
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34787-4767
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-279-0480
Provider Business Mailing Address Fax Number:
321-231-7385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17011 STATE ROAD 50
Provider Second Line Business Practice Location Address:
STE 103
Provider Business Practice Location Address City Name:
CLERMONT
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-279-0480
Provider Business Practice Location Address Fax Number:
321-231-7385
Provider Enumeration Date:
09/20/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  9542416 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WL0100X , with the licence number: L-144013 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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