Provider Demographics
NPI:1023017217
Name:WERNICKI, JOANNE WOJICK (MD)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:WOJICK
Last Name:WERNICKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1485 37TH ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6500
Mailing Address - Country:US
Mailing Address - Phone:772-569-9745
Mailing Address - Fax:772-567-6868
Practice Address - Street 1:1485 37TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6500
Practice Address - Country:US
Practice Address - Phone:772-569-9745
Practice Address - Fax:772-567-6868
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00573992085B0100X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052809900Medicaid
FL052809900Medicaid
FL11557XMedicare PIN