Provider Demographics
NPI:1144459215
Name:WOODS LYNNE, CAITLYN (OD)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:WOODS LYNNE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9624 RENWICK CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5997
Mailing Address - Country:US
Mailing Address - Phone:610-836-2779
Mailing Address - Fax:
Practice Address - Street 1:2050 OLD HICKORY TREE RD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-8926
Practice Address - Country:US
Practice Address - Phone:407-556-3969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002261152W00000X
FLOPC 4697152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist