Wood, Malissa J
Wood, Malissa J is an individual health care provider with primary practice located at 9800 S Healthpark Dr Ste 320 , Fort Myers FL 33908-3630. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Wood, Malissa J can be contacted via phone (239) 343-6350.Contact Information
Primary practice address
9800 S Healthpark Dr Ste 320
Fort Myers FL 33908-3630
Phone: (239) 343-6350
Fax: (239) 343-4738
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 70796 | Massachusetts |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 70796 | Massachusetts |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | ME128089 | Florida |
Profile Details
| NPI number | 1154312056 |
|---|---|
| LBN Legal business name | Wood, Malissa J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Aug 2nd, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154312056 | NPPES |
| Massachusetts | Other | J22884 | BCBS MA |
| Massachusetts | MEDICAID | 0106712 | BCBS MA |
| Massachusetts | Other | 070796 | BCBS MA |
| Massachusetts | MEDICAID | 118282400 | BCBS MA |
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