Provider Demographics
NPI:1346691987
Name:WOLFE, EMILY R (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:R
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 N SR 434 STE 1285
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7057
Mailing Address - Country:US
Mailing Address - Phone:407-635-5514
Mailing Address - Fax:407-636-7856
Practice Address - Street 1:931 N SR 434 STE 1285
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-7057
Practice Address - Country:US
Practice Address - Phone:407-635-5514
Practice Address - Fax:407-636-7856
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME139791208000000X
FLTRN23684390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program