MEDICARE: DONNA WOLF PA-C

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	363A00000X	Physician Assistant	PA9119941	FL

General Provider Information

NPI Number	:	1447963343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA WOLF PA-C

Provider Business Mailing Address
First Line	:	600 S PINE ISLAND RD STE 102
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3178
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 S PINE ISLAND RD STE 102
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3178
Country	:	US
Telephone Number	:	954-635-6243
Fax Number	:

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

Provider Enumeration Date	:	01/05/2023
Last Update Date	:	12/05/2025

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Directions to “ DONNA WOLF PA-C” Practice Location

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