MEDICARE: DAVID MICHAEL WOOD FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11020057	FL

General Provider Information

NPI Number	:	1174254908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MICHAEL WOOD FNP-C

Provider Business Mailing Address
First Line	:	2720 US HIGHWAY 1 S STE B
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32086-6371
Country	:	US
Telephone Number	:	904-827-0078
Fax Number	:	904-827-0140

Provider Business Practice Location Address
First Line	:	2720 US HIGHWAY 1 S STE B
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32086-6371
Country	:	US
Telephone Number	:	904-827-0078
Fax Number	:	904-827-0140

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	07/29/2024

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