Provider Demographics
NPI:1164473336
Name:WOEHRER, RENEE M (MD)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:M
Last Name:WOEHRER
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 1:4278 W LINEBAUGH AVE STE B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-5241
Mailing Address - Country:US
Mailing Address - Phone:813-960-3321
Mailing Address - Fax:813-264-7532
Practice Address - Street 1:4278 W LINEBAUGH AVE STE B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-5241
Practice Address - Country:US
Practice Address - Phone:813-960-3321
Practice Address - Fax:813-264-7532
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20763207R00000X
FLME170064207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078557589Medicaid
NE47078557589Medicaid
NE271693Medicare ID - Type Unspecified