Individual
MR. RANDLY LYSANDER WOODS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7487 S STATE ROAD 121, MACCLENNY, FL 32063-5451
(904) 259-6211
(904) 259-7104
Mailing address
7487 S STATE ROAD 121, MACCLENNY, FL 32063-5451
(904) 259-6211
(904) 259-7104
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
08-00277
KS
2084P0800X
Psychiatry Physician
Primary
ME102215
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003141300
—
FL
Enumeration date
07/31/2006
Last updated
08/08/2011
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