Healthcare Provider Details

I. General information

NPI: 1861329104
Provider Name (Legal Business Name): WULFF MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1952 N WILLIAMSON BLVD
DAYTONA BEACH FL
32117-5261
US

IV. Provider business mailing address

PO BOX 1540
EDGEWATER FL
32132-8540
US

V. Phone/Fax

Practice location:
  • Phone: 386-363-2000
  • Fax: 386-676-2555
Mailing address:
  • Phone: 386-676-0255
  • Fax: 386-676-2555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KRISTIN LYNELLE WULFF
Title or Position: OWNER
Credential: MD
Phone: 386-238-9064