Provider Demographics
NPI:1265604904
Name:WOLCOTT CONSULTING LLC
Entity type:Organization
Organization Name:WOLCOTT CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:WOLCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA ARNP
Authorized Official - Phone:772-388-3344
Mailing Address - Street 1:1511 US HIGHWAY 1 STE 104
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-1611
Mailing Address - Country:US
Mailing Address - Phone:772-388-3344
Mailing Address - Fax:772-388-4002
Practice Address - Street 1:1511 US HIGHWAY 1 STE 104
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-1611
Practice Address - Country:US
Practice Address - Phone:772-388-3344
Practice Address - Fax:772-388-4002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9203833208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 9203833OtherLICENSE