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Individual

DR. JONATHAN F WISE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3816 HOLLYWOOD BLVD, SUITE 101, HOLLYWOOD, FL 33021-6750
(954) 963-4990
(954) 963-1848
Mailing address
3816 HOLLYWOOD BLVD, SUITE 101, HOLLYWOOD, FL 33021-6750
(954) 963-4990
(954) 963-1848

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MEOO34543

Other

Enumeration date
04/19/2006
Last updated
07/09/2007
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