Provider Demographics
NPI:1619042918
Name:WOODRUFF, CHRISTOPHER EDWIN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:EDWIN
Last Name:WOODRUFF
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1683 ISLAND WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3625
Mailing Address - Country:US
Mailing Address - Phone:954-384-0497
Mailing Address - Fax:
Practice Address - Street 1:3200 S UNIVERSITY DR
Practice Address - Street 2:NSU THE EYE INSTITUTE SUITE 1402
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2018
Practice Address - Country:US
Practice Address - Phone:954-262-1402
Practice Address - Fax:954-262-1818
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2782152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT96103Medicare UPIN
FL20518Medicare ID - Type Unspecified