Provider Demographics
NPI:1558323782
Name:WOODING, AMY (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:
Last Name:WOODING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:TERMINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:29277 US 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2102
Mailing Address - Country:US
Mailing Address - Phone:727-313-4764
Mailing Address - Fax:
Practice Address - Street 1:29277 US 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2102
Practice Address - Country:US
Practice Address - Phone:727-313-4764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102645246ZC0007X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00290634OtherRAILROAD MEDICARE
FL2923696 00Medicaid
S97520Medicare UPIN
FLU2020YMedicare PIN
FLU2020XMedicare PIN