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General NPI Number Information
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NPI Number | 1205254372
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Entity Type | Individual
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Provider Name | CASEY JOAN WOODY M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/04/2014
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Last Update Date | 10/26/2018
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Provider Practice Location Address
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Address Line | 3340 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-1974
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Country | US
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Telephone | 863-682-3239
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Fax |
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Provider Business Mailing Address
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Address Line | 8633 VISTA SHORES CT
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City | ORLANDO
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State | FL
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Zip | 32836-6325
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Country | US
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Telephone | 407-256-3331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME138077
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License Number State | FL
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