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NPI Code Detail

MEDICARE: DR. BENNETT LLOYD WOLANSKY D.P.M.

MEDICARE: DR. BENNETT LLOYD WOLANSKY D.P.M.
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
1213ES0131XFoot Surgery PodiatristPO0002066FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679550388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BENNETT LLOYD WOLANSKY D.P.M.
Provider Business Mailing Address
First Line : 4601 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-3817
Country : US
Telephone Number : 954-680-7133
Fax Number : 954-680-7135
Provider Business Practice Location Address
First Line : 4601 S UNIVERSITY DR
Second Line :
City : DAVIE
State : FL
Zip : 33328-3817
Country : US
Telephone Number : 954-680-7133
Fax Number : 954-680-7135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 06/26/2010

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