1831068253 NPI number — PINELLAS COMMUNITY CARE DIAGNOSTIC CENTER

Table of content: DANIEL PAUL WOYDICK MD (NPI 1114020021)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831068253 NPI number — PINELLAS COMMUNITY CARE DIAGNOSTIC CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PINELLAS COMMUNITY CARE DIAGNOSTIC CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831068253
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 2ND AVE SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LARGO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33770-3120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 2ND AVE SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LARGO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33770-3120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-851-5322
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2025

Additional Information

Authorized Official

Authorized Official Last Name:
MOHL
Authorized Official First Name:
RYAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING SUPPORT
Authorized Official Telephone Number:
616-490-9299

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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