Healthcare Provider Details

I. General information

NPI: 1437185774
Provider Name (Legal Business Name): DAVID J.D WOSKA M.D., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 N WYMORE RD SUITE 101
WINTER PARK FL
32789-2859
US

IV. Provider business mailing address

650 N WYMORE RD SUITE 101
WINTER PARK FL
32789-2859
US

V. Phone/Fax

Practice location:
  • Phone: 407-645-4320
  • Fax: 407-645-5350
Mailing address:
  • Phone: 407-645-4320
  • Fax: 407-645-5350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID J.D. WOSKA
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 407-645-4320