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General NPI Number Information
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NPI Number | 1184140683
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Entity Type | Organization
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Legal Business Name | LIVE OAK NEUROSURGICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 1555 N PALAFOX ST
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City | PENSACOLA
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State | FL
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Zip | 32501-2134
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Country | US
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Telephone | 850-512-3482
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Fax | 850-969-2130
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Provider Business Mailing Address
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Address Line | PO BOX 2243
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City | PENSACOLA
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State | FL
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Zip | 32513-2243
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Country | US
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Telephone | 850-478-1312
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Fax | 850-474-9060
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES L WOLFF
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Credential | MD
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Telephone | 850-890-7706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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