Provider Demographics
NPI:1225089048
Name:WOLFF, BRIAN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DAVID
Last Name:WOLFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 GOODLETTE RD N
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5469
Mailing Address - Country:US
Mailing Address - Phone:239-643-4030
Mailing Address - Fax:239-643-6010
Practice Address - Street 1:671 GOODLETTE RD N
Practice Address - Street 2:SUITE 120
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5469
Practice Address - Country:US
Practice Address - Phone:239-643-4030
Practice Address - Fax:239-643-6010
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00617192084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL17829OtherBCBS
FL17829OtherBCBS
FL17829UMedicare ID - Type Unspecified
FLDW2413778OtherDEA