Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PTA27978 | FL |
NPI | 1003449760 |
---|---|
Provider Name | Carolyn Woods |
First Address | Deland, FL 32720 |
Second Address | Mount Dora, FL 32757-2105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2020 |
Last Update Date | 20/02/2020 |