Provider Demographics
NPI:1154367266
Name:WOODS, VICTORIA D (MD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:D
Last Name:WOODS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7929
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33734-7929
Mailing Address - Country:US
Mailing Address - Phone:727-641-7788
Mailing Address - Fax:727-525-9459
Practice Address - Street 1:1200 7TH AVE NORTH
Practice Address - Street 2:ST. ANTHONY'S HEALTH CARE-WOUND HEALING CENTER
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33734
Practice Address - Country:US
Practice Address - Phone:727-825-1687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62507207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18330WMedicare ID - Type Unspecified