MEDICARE: JOHN WOESTE JR MD & ASSOC PA

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
1	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1639280233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN WOESTE JR MD & ASSOC PA

Provider Business Mailing Address
First Line	:	PO BOX 863432
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32886-3432
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1577 ROBERTS DR
Second Line	:	SUITE 326
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3264
Country	:	US
Telephone Number	:	904-270-2706
Fax Number	:	904-270-2715

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JOHN T WOESTE JR.
Credential	:	MD
Telephone Number	:	904-270-2706

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/04/2013

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