Provider Demographics
NPI:1427046192
Name:KOREFF-WOLF, BONNIE S (MD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:S
Last Name:KOREFF-WOLF
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 1:11903 PALERMO RD
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-4694
Mailing Address - Country:US
Mailing Address - Phone:315-439-3246
Mailing Address - Fax:972-947-5277
Practice Address - Street 1:11903 PALERMO RD
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-4694
Practice Address - Country:US
Practice Address - Phone:315-439-3246
Practice Address - Fax:972-947-5277
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138038207R00000X
NY1602321207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01058391Medicaid
NY01058391Medicaid
NYCC1321Medicare ID - Type Unspecified