Provider Demographics
NPI:1407020944
Name:WOLFGRAM, MARIA F (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:F
Last Name:WOLFGRAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 FLORIDA AVE S
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2145
Mailing Address - Country:US
Mailing Address - Phone:321-637-7700
Mailing Address - Fax:321-637-7707
Practice Address - Street 1:1022 FLORIDA AVE S
Practice Address - Street 2:SUITE 6
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2145
Practice Address - Country:US
Practice Address - Phone:321-637-7700
Practice Address - Fax:321-637-7707
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2988782163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics