Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 9314570 | FL |
NPI | 1003117847 |
---|---|
Provider Name | Beth R Wolf |
First Address | Miami, FL 33162-2662 |
Second Address | Miami, FL 33137-2706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2010 |
Last Update Date | 03/03/2021 |