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General NPI Number Information
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NPI Number | 1639490642
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Entity Type | Organization
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Legal Business Name | WOLFE & WOLFE ENTERPRISES INC
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 06/16/2010
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Provider Practice Location Address
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Address Line | 100 DOCTORS DR SUITE C
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City | PANAMA CITY
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State | FL
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Zip | 32405-7608
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Country | US
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Telephone | 850-814-8400
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Fax | 850-747-8836
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Provider Business Mailing Address
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Address Line | 220 HARMON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-5801
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Country | US
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Telephone | 850-814-8400
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Fax | 850-215-8405
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. WANEDA KAY WOLFE
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Credential | ARNP
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Telephone | 850-814-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ARNP3417872
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License Number State | FL
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