Individual
MR. RANDY DALE WOODARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
5971 TERRACE PARK DR N, UNIT 108, SAINT PETERSBURG, FL 33709-1181
(727) 742-8172
Mailing address
5971 TERRACE PARK DR N, UNIT 108, SAINT PETERSBURG, FL 33709-1181
(727) 742-8172
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
219819-1
NY
164W00000X
Licensed Practical Nurse
Primary
PN 5185890
FL
Other
Enumeration date
05/11/2012
Last updated
05/11/2012
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