Provider Demographics
NPI:1639490642
Name:WOLFE & WOLFE ENTERPRISES INC
Entity Type:Organization
Organization Name:WOLFE & WOLFE ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:WANEDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:850-814-8400
Mailing Address - Street 1:220 HARMON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-5801
Mailing Address - Country:US
Mailing Address - Phone:850-814-8400
Mailing Address - Fax:850-215-8405
Practice Address - Street 1:100 DOCTORS DR
Practice Address - Street 2:SUITE C
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-7608
Practice Address - Country:US
Practice Address - Phone:850-814-8400
Practice Address - Fax:850-747-8836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3417872261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1013007723OtherNPI