Provider Demographics
NPI:1366220451
Name:WINES, CELIA (FNP-C)
Entity type:Individual
Prefix:
First Name:CELIA
Middle Name:
Last Name:WINES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 E ANNA JO DR
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-8411
Mailing Address - Country:US
Mailing Address - Phone:352-220-0122
Mailing Address - Fax:
Practice Address - Street 1:7648 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:FLORAL CITY
Practice Address - State:FL
Practice Address - Zip Code:34436-2738
Practice Address - Country:US
Practice Address - Phone:352-726-3700
Practice Address - Fax:352-726-8570
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028718363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care