Healthcare Provider Details

I. General information

NPI: 1053233585
Provider Name (Legal Business Name): PAIGE MORGAN WOODWORTH PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3830 EVANS AVE
FORT MYERS FL
33901-9305
US

IV. Provider business mailing address

3830 EVANS AVE
FORT MYERS FL
33901-9305
US

V. Phone/Fax

Practice location:
  • Phone: 239-939-2808
  • Fax: 239-939-4794
Mailing address:
  • Phone: 239-939-2808
  • Fax: 239-939-4794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number11048743
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: