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General NPI Number Information
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NPI Number | 1487960944
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Entity Type | Organization
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Legal Business Name | EMMANUELA WOLLOCH, MD, PA
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Dates
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Enumeration Date | 08/23/2010
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 400 ARTHUR GODFREY RD SUITE 305
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3516
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Country | US
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Telephone | 305-531-7130
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Fax | 305-531-0794
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Provider Business Mailing Address
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Address Line | 400 ARTHUR GODFREY RD SUITE 305
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3516
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Country | US
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Telephone | 305-531-7130
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Fax | 305-531-0794
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Authorized Official
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Title or Position | PRESIDENT
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Name | EMMANUELA WOLLOCH
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Credential |
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Telephone | 305-531-7130
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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 | 59103
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License Number State | FL
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