Provider Demographics
NPI:1053394171
Name:WOOD, MICHELLE ELESE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ELESE
Last Name:WOOD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:601 E DIXIE AVE
Mailing Address - Street 2:MEDICAL PLAZA #401
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5953
Mailing Address - Country:US
Mailing Address - Phone:352-787-1535
Mailing Address - Fax:352-787-5310
Practice Address - Street 1:1307 S PINE AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-6543
Practice Address - Country:US
Practice Address - Phone:352-368-2238
Practice Address - Fax:352-368-5042
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-12-27
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Provider Licenses
StateLicense IDTaxonomies
FLME87437174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH86024Medicare UPIN