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Individual

SELLY WOLKOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1610 SHERIDAN ST, HOLLYWOOD, FL 33020-2306
(954) 922-7400
(954) 925-1327
Mailing address
1610 SHERIDAN ST, HOLLYWOOD, FL 33020-2306
(954) 922-7400
(954) 925-1327

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME51678
FL
208D00000X
General Practice Physician
Primary
ME0051678
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
268680500
FL
Enumeration date
09/07/2006
Last updated
05/04/2015
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