Provider Demographics
NPI:1730232364
Name:WOODS, ABRAHAM L III (MD)
Entity type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:L
Last Name:WOODS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BOSTON AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4731
Mailing Address - Country:US
Mailing Address - Phone:407-830-4777
Mailing Address - Fax:407-830-4762
Practice Address - Street 1:106 BOSTON AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4731
Practice Address - Country:US
Practice Address - Phone:407-830-4777
Practice Address - Fax:407-830-4762
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053129174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB63663Medicare UPIN
FL14364AMedicare ID - Type Unspecified