Healthcare Provider Details

I. General information

NPI: 1588577001
Provider Name (Legal Business Name): DESRAE YVETTE WOODS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2971 DRIFTING OAK PL APT 300
APOPKA FL
32703-0029
US

IV. Provider business mailing address

2971 DRIFTING OAK PL APT 300
APOPKA FL
32703-0029
US

V. Phone/Fax

Practice location:
  • Phone: 786-510-9699
  • Fax:
Mailing address:
  • Phone: 786-510-9699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS71598
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: