MEDICARE: LINDSEY REPASS WOLF PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA9102892	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA9102892	OTHER	FL	FL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306845276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY REPASS WOLF PA

Provider Business Mailing Address
First Line	:	1340 TUSKAWILLA RD STE 101-5
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-5030
Country	:	US
Telephone Number	:	407-699-1160
Fax Number	:	407-699-7861

Provider Business Practice Location Address
First Line	:	1340 TUSKAWILLA RD STE 101-5
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-5030
Country	:	US
Telephone Number	:	407-699-1160
Fax Number	:	407-699-7861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	10/24/2016

Similar Medicare Providers

1568415503 — JOHN W TREHARNE MD
Practice Location Address:

1340 TUSKAWILLA RD , SUITE 101-105
WINTER SPRINGS, FL
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Practice Phone: 407-699-1160
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1548215734 — LAWRENCE D KRAMER DO
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1164478053 — JOHN L LEY PA-C
Practice Location Address:

1340 TUSKAWILLA RD , SUITE 101-105
WINTER SPRINGS, FL
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Practice Fax: 407-699-7861

1336182856 — MRS. KENNA LAINE WARE AP, DOM
Practice Location Address:

1340 TUSKAWILLA RD STE 111
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1770510372 — DR. DANIEL LEE COCHRAN MD
Practice Location Address:

1340 TUSKAWILLA RD STE 101-5
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1306879200 — DR. ROBERT DARRELL MATTESON D.M.D.
Practice Location Address:

1340 TUSKAWILLA RD , 108
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Practice Fax:

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