Provider Demographics
NPI:1366613598
Name:WOOD, DONALD LEE (CRNA ARNP)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:LEE
Last Name:WOOD
Suffix:
Gender:M
Credentials:CRNA ARNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:216 MIRROR LAKE DR
Mailing Address - Street 2:
Mailing Address - City:INTERLACHEN
Mailing Address - State:FL
Mailing Address - Zip Code:32148-7359
Mailing Address - Country:US
Mailing Address - Phone:386-546-6436
Mailing Address - Fax:904-212-0361
Practice Address - Street 1:216 MIRROR LAKE DR
Practice Address - Street 2:
Practice Address - City:INTERLACHEN
Practice Address - State:FL
Practice Address - Zip Code:32148-7359
Practice Address - Country:US
Practice Address - Phone:386-546-6436
Practice Address - Fax:904-212-0361
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-15
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP 697062367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered