MEDICARE: JOHN WOODY MD

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	ME0056404	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00017793	OTHER	FL	RAILROAD MEDICARE

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
2	08362	OTHER	FL	BLUE CROSS BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972559847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN WOODY MD

Provider Business Mailing Address
First Line	:	PO BOX 863258
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32886-3258
Country	:	US
Telephone Number	:	352-867-8898
Fax Number	:	352-732-6282

Provider Business Practice Location Address
First Line	:	3340 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-1974
Country	:	US
Telephone Number	:	352-867-8898
Fax Number	:	352-732-6282

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	10/26/2018

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Directions to “ JOHN WOODY MD” Practice Location

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