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NPI Code Detail

MEDICARE: MR. ROBERT STEPHEN WOODWARD OTR/L

MEDICARE:  MR. ROBERT STEPHEN WOODWARD  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist11093FL

General Provider Information

NPI Number : 1013193143
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT STEPHEN WOODWARD OTR/L
Provider Business Mailing Address
First Line : 4828 SCOTCH PINE CT
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32210-7917
Country : US
Telephone Number : 904-317-6064
Fax Number :
Provider Business Practice Location Address
First Line : 4828 SCOTCH PINE CT
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32210-7917
Country : US
Telephone Number : 904-317-6064
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2008
Last Update Date : 01/18/2008

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Directions to “ MR. ROBERT STEPHEN WOODWARD OTR/L” Practice Location

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