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General NPI Number Information
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NPI Number | 1417164005
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Entity Type | Individual
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Provider Name | ROCHELLE A WOLFE M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 1800 SE TIFFANY AVE
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7521
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Country | US
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Telephone | 772-335-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 DAHLBERG DR STE 300
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City | GOLDEN VALLEY
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State | MN
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Zip | 55422-4841
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Country | US
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Telephone | 952-512-5600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 49635
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 49635
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | ME145863
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License Number State | FL
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