Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | ME44600 | FL |
Y | 207RH0002X | Hospice and Palliative Medicine | ME44600 | FL |
NPI | 1124019724 |
---|---|
Provider Name | Deidra R Woods |
First Address | St Petersburg, FL 33713-7147 |
Second Address | St Petersburg, FL 33713-7147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 21/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
44600 | (05) | FL |
E53999 | (02) | FL |
ME0044600 | MEDICAL DOCTOR (01) | FL |