MEDICARE: DR. DANIEL WOLFSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	ME0098505	FL

General Provider Information

NPI Number	:	1124230958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL WOLFSON MD

Provider Business Mailing Address
First Line	:	4300 ALTON RD
Second Line	:	#810
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2800
Country	:	US
Telephone Number	:	305-674-5925
Fax Number	:	305-674-5927

Provider Business Practice Location Address
First Line	:	4300 ALTON ROAD SUITE #810
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3110
Country	:	US
Telephone Number	:	305-674-5925
Fax Number	:	305-674-5927

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	02/22/2010

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