Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | ME 114716 | FL |
Y | 207QS0010X | Family Doctor - Sports Medicine | ME114716 | FL |
NPI | 1003103060 |
---|---|
Provider Name | Katherine Flachs Wojnowich |
First Address | Saint Petersburg, FL 33701-4719 |
Second Address | Saint Petersburg, FL 33701-4719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2011 |
Last Update Date | 08/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015570100 | (05) | FL |