Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME113169 | FL |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | ME113169 | FL |
NPI | 1477747731 |
---|---|
Provider Name | Clive Woods |
First Address | Plantation, FL 33324-2703 |
Second Address | Plantation, FL 33324-2703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2007 |
Last Update Date | 09/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0871917 | CIGNA (01) | FL |