Healthcare Provider Details

I. General information

NPI: 1558371195
Provider Name (Legal Business Name): WOODRUFF INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2235 VENETIAN CT
NAPLES FL
34109-8728
US

IV. Provider business mailing address

2235 VENETIAN CT
NAPLES FL
34109-8728
US

V. Phone/Fax

Practice location:
  • Phone: 239-596-9337
  • Fax: 239-596-9466
Mailing address:
  • Phone: 239-596-9337
  • Fax: 239-596-9466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. REBECCA WOODRUFF LAMBERT
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 239-596-9337