Provider Demographics
NPI:1043864481
Name:WINKE, MATTHEW CHARLES (DACM, AP)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:CHARLES
Last Name:WINKE
Suffix:
Gender:M
Credentials:DACM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 NW 53RD ST STE 125
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-8236
Mailing Address - Country:US
Mailing Address - Phone:424-387-1800
Mailing Address - Fax:
Practice Address - Street 1:621 NW 53RD ST STE 125
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-8236
Practice Address - Country:US
Practice Address - Phone:424-387-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18636171100000X
NJ25MZ00142900171100000X
FLAP4264171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist