Healthcare Provider Details
I. General information
NPI: 1891909073
Provider Name (Legal Business Name): LINDA ANN WOODARD D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8770 SW 72ND ST # 285
MIAMI FL
33173-3512
US
IV. Provider business mailing address
8770 SW 72ND ST # 285
MIAMI FL
33173-3512
US
V. Phone/Fax
- Phone: 786-768-1875
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | FL OS 7472 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: