Provider Demographics
NPI:1114427705
Name:ABRAHAM L WOODS III, M.D., PA
Entity Type:Organization
Organization Name:ABRAHAM L WOODS III, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JUMPER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:646-408-5860
Mailing Address - Street 1:106 BOSTON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4711
Mailing Address - Country:US
Mailing Address - Phone:407-830-4777
Mailing Address - Fax:407-830-4762
Practice Address - Street 1:106 BOSTON AVE STE 103
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4711
Practice Address - Country:US
Practice Address - Phone:407-830-4777
Practice Address - Fax:407-830-4762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53129208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty