MEDICARE: DR. CASEY JOAN WOODY M.D.

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	207L00000X	Anesthesiology Physician	ME138077	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205254372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CASEY JOAN WOODY M.D.

Provider Business Mailing Address
First Line	:	8633 VISTA SHORES CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32836-6325
Country	:	US
Telephone Number	:	407-256-3331
Fax Number	:

Provider Business Practice Location Address
First Line	:	3340 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-1974
Country	:	US
Telephone Number	:	863-682-3239
Fax Number	:

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

Provider Enumeration Date	:	04/04/2014
Last Update Date	:	10/26/2018

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