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NPI 1912971979

NPI 1912971979 : SAMUEL S WOOCIKER DPM : ORLANDO, FL

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General NPI Number Information
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    NPI Number           |    1912971979
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    Entity Type          |    Individual 
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    Provider Name        |    SAMUEL S WOOCIKER DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/15/2006
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    Last Update Date     |    08/27/2020
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Provider Practice Location Address
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    Address Line         |    2014 S ORANGE AVE SUITE 100
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32806-3069
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    Country              |    US
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    Telephone            |    407-423-1234
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    Fax                  |    407-517-1040
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Provider Business Mailing Address
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    Address Line         |    445 WARRIOR TRL 
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    City                 |    ENTERPRISE
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    State                |    FL
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    Zip                  |    32725-2456
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    Country              |    US
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    Telephone            |    407-376-0522
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    Fax                  |    407-386-3077
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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        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    PO 1323
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    License Number State |    FL
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