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Individual

JOHN S WOODYARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
37944 CHURCH AVE, DADE CITY, FL 33525-4207
(352) 518-2000
(352) 567-1974
Mailing address
PO BOX 232, DADE CITY, FL 33526-0232
(352) 518-2000
(352) 567-1974

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9106127
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA9106127
LICENSE
FL
Enumeration date
09/09/2011
Last updated
09/09/2011
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