Individual ProviderLaurie WoodardFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address12901 Bruce B Downs Blvd, Tampa, FL 33612-4742(813) 974-2918(813) 974-2201PECOS EnrollmentBased on the most recent information from CMS, provider Laurie Woodard does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1225060981Provider TypeIndividualFull NameWoodard, LaurieCredentialMDGenderFemaleSole ProprietorNoEnumeration Date7/6/2006Last Updated3/22/2021Contact InformationPractice LocationPractice Address12901 Bruce B Downs Blvd, Tampa, FL 33612-4742Phone(813) 974-2918Fax(813) 974-3326Mailing LocationMailing AddressPO Box 917770, Orlando, FL 32891-0001Phone(813) 974-2201Fax(813) 974-4325Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseME49197FloridaProvider IdentifiersIDDescriptionIssuerID03913DescriptionOtherIssuerBLUE CROSS BLUE SHIELDFloridaID047586600DescriptionMedicaidIssuerUnlistedFlorida