Provider Demographics
NPI:1639381205
Name:WOLSTENHOLME, ANA MARIA
Entity Type:Individual
Prefix:DR
First Name:ANA MARIA
Middle Name:
Last Name:WOLSTENHOLME
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ANNA MARIE
Other - Middle Name:
Other - Last Name:WOLSTENHOLME
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:380 NE 91ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-3130
Mailing Address - Country:US
Mailing Address - Phone:786-385-3438
Mailing Address - Fax:
Practice Address - Street 1:380 NE 91ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-3130
Practice Address - Country:US
Practice Address - Phone:786-385-3438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34281183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist