MEDICARE: MR. GERARD HENRY WOODIN

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	237700000X	Hearing Instrument Specialist	AS-3085	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659315455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GERARD HENRY WOODIN

Provider Business Mailing Address
First Line	:	PO BOX 406153
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-1876
Country	:	US
Telephone Number	:	561-478-8770
Fax Number	:	561-688-8877

Provider Business Practice Location Address
First Line	:	600 E ALTAMONTE DR
Second Line	:	SUITE 1000
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-4815
Country	:	US
Telephone Number	:	407-331-8883
Fax Number	:	407-331-3996

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	10/08/2008

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