Provider Demographics
NPI:1437185774
Name:DAVID J.D WOSKA M.D., PA
Entity Type:Organization
Organization Name:DAVID J.D WOSKA M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JD
Authorized Official - Last Name:WOSKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-645-4320
Mailing Address - Street 1:650 N WYMORE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2859
Mailing Address - Country:US
Mailing Address - Phone:407-645-4320
Mailing Address - Fax:407-645-5350
Practice Address - Street 1:650 N WYMORE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2859
Practice Address - Country:US
Practice Address - Phone:407-645-4320
Practice Address - Fax:407-645-5350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007138600Medicaid
FL007138600Medicaid
FLGS154AMedicare Oscar/Certification