Provider Demographics
NPI:1922087568
Name:WOLF, JOHN S JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:WOLF
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 W OAKLAND PARK BLVD
Mailing Address - Street 2:#202
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-1016
Mailing Address - Country:US
Mailing Address - Phone:954-253-4467
Mailing Address - Fax:
Practice Address - Street 1:7000 W OAKLAND PARK BLVD
Practice Address - Street 2:#202
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-1016
Practice Address - Country:US
Practice Address - Phone:954-253-4467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME27172207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1749OtherBCBS
FLD70181Medicare UPIN