Healthcare Provider Details

I. General information

NPI: 1124230958
Provider Name (Legal Business Name): DR. DANIEL WOLFSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 SOLE MIA WAY
NORTH MIAMI FL
33181-2492
US

IV. Provider business mailing address

2111 SOLE MIA WAY
NORTH MIAMI FL
33181-2492
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-8644
  • Fax: 305-689-1820
Mailing address:
  • Phone: 305-243-8644
  • Fax: 305-689-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME98505
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: