Individual
DR. MALISSA J WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9800 S HEALTHPARK DR STE 320, FORT MYERS, FL 33908-3630
(239) 343-6350
(239) 343-4738
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6350
(239) 343-4738
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
70796
MA
207RC0000X
Cardiovascular Disease Physician
70796
MA
207RC0000X
Cardiovascular Disease Physician
Primary
ME128089
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0106712
—
MA
01
—
070796
TUFTS HEALTH PLAN
MA
05
—
118282400
—
FL
01
—
J22884
BCBS MA
MA
Enumeration date
10/31/2005
Last updated
08/02/2023
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