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General NPI Number Information
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NPI Number | 1467719567
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Entity Type | Organization
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Legal Business Name | BRUCE D WOLOSKY DPM, PA
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 8534 SW HIGHWAY 200
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City | OCALA
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State | FL
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Zip | 34481-2100
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Country | US
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Telephone | 352-237-2002
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Fax | 352-861-3162
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Provider Business Mailing Address
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Address Line | 8534 SW HIGHWAY 200
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City | OCALA
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State | FL
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Zip | 34481
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Country | US
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Telephone | 352-237-2002
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Fax | 352-861-3162
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. BRUCE DAVID WOLOSKY
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Credential | DPM
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Telephone | 352-237-2002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO2270
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License Number State | FL
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