Provider Demographics
NPI:1477789378
Name:WOODS, STEFANIE H (DOM)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:H
Last Name:WOODS
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 OCEAN LN
Mailing Address - Street 2:
Mailing Address - City:ISLAMORADA
Mailing Address - State:FL
Mailing Address - Zip Code:33036-3913
Mailing Address - Country:US
Mailing Address - Phone:305-394-0668
Mailing Address - Fax:
Practice Address - Street 1:82913 OVERSEAS HWY
Practice Address - Street 2:
Practice Address - City:ISLAMORADA
Practice Address - State:FL
Practice Address - Zip Code:33036-3638
Practice Address - Country:US
Practice Address - Phone:305-394-0668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2672171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist