Healthcare Provider Details

I. General information

NPI: 1780567263
Provider Name (Legal Business Name): CYNTHIA D WOOLERY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 NW 338TH ST
OKEECHOBEE FL
34972-0213
US

IV. Provider business mailing address

1850 NW 338TH ST
OKEECHOBEE FL
34972-0213
US

V. Phone/Fax

Practice location:
  • Phone: 404-275-8592
  • Fax:
Mailing address:
  • Phone: 404-275-8592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11040906
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: