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General NPI Number Information
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NPI Number | 1417902164
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Entity Type | Individual
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Provider Name | DALE EDWIN WOLFORD DO
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Gender | Male
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 1110 E GIBSON ST
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City | ARCADIA
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State | FL
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Zip | 34266-5011
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Country | US
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Telephone | 863-494-1918
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Fax | 863-993-2116
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Provider Business Mailing Address
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Address Line | 700 8TH AVE W STE 101
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City | PALMETTO
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State | FL
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Zip | 34221-4737
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Country | US
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Telephone | 941-776-4008
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Fax | 941-845-4963
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | H0063736
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | OS4624
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License Number State | FL
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