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General NPI Number Information
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NPI Number | 1659667376
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Entity Type | Organization
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Legal Business Name | BETSY E. WOOD DO PA
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Dates
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Enumeration Date | 06/21/2011
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Last Update Date | 06/21/2011
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Provider Practice Location Address
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Address Line | 1100 W STRYKER RD
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City | AVON PARK
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State | FL
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Zip | 33825-7300
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Country | US
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Telephone | 863-453-7400
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Fax | 863-452-1981
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Provider Business Mailing Address
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Address Line | 1100 W STRYKER RD
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City | AVON PARK
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State | FL
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Zip | 33825-7300
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Country | US
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Telephone | 863-453-7400
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Fax | 863-452-1981
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BETSY ELLEN WOOD
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Credential | D.O.
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Telephone | 863-368-0538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OS8123
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License Number State | FL
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