Wood, Tamara Michelle

Wood, Tamara Michelle is an individual health care provider with primary practice located at 630 N Main St , Williston FL 32696-1705. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Wood, Tamara Michelle can be contacted via phone (352) 528-0587.

Contact Information

Primary practice address
630 N Main St Williston FL 32696-1705
Phone: (352) 528-0587
Fax: (352) 463-2726
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA 9106033 Florida

Profile Details

NPI number 1508154956
LBN Legal business name Wood, Tamara Michelle
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2011
Last updated Feb 8th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508154956 NPPES
Florida MEDICAID 003937900

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