Provider Demographics
NPI:1518082262
Name:MONICA O WOODWARD MD PA
Entity Type:Organization
Organization Name:MONICA O WOODWARD MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:O
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-254-1233
Mailing Address - Street 1:1865 VETERANS PARK DR STE 301
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0447
Mailing Address - Country:US
Mailing Address - Phone:239-254-1233
Mailing Address - Fax:239-254-1255
Practice Address - Street 1:1865 VETERANS PARK DR STE 301
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0447
Practice Address - Country:US
Practice Address - Phone:239-254-1233
Practice Address - Fax:239-254-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94937OtherBLUE CROSS BLUE SHIELD
FL94937OtherBLUE CROSS BLUE SHIELD