Provider Demographics
NPI:1003103060
Name:WOJNOWICH, KATHERINE FLACHS (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:FLACHS
Last Name:WOJNOWICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:BOOTH
Other - Last Name:FLACHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:603 7TH S ST 440
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4719
Mailing Address - Country:US
Mailing Address - Phone:727-893-6333
Mailing Address - Fax:727-553-7787
Practice Address - Street 1:603 7TH S ST 440
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4719
Practice Address - Country:US
Practice Address - Phone:727-893-6333
Practice Address - Fax:727-553-7787
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 114716207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015570100Medicaid
FLIH113ZMedicare PIN