SELLY WOLKOV (NPI# 1407959836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407959836 |
| Entity Type | Individual |
| Full Name | SELLY WOLKOV |
| Credential | MD |
| Practice Address |
1610 Sheridan St Hollywood FL 33020-2306 |
| Practice Telephone | 9549227400 |
| Practice Fax Number | 9549251327 |
| Mailing Telephone | 9549227400 |
| Mailing Fax Number | 9549251327 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2015-05-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | ME51678 | FL | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | ME0051678 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 268680500 | 05 |
| Street Address |
1610 SHERIDAN ST |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33020-2306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972003135 | Diana Carmona | Nurse Practitioner | 1610 Sheridan St, Hollywood, FL 33020-2306 | 2018-02-14 |
| 1497068472 | Amca Medical Services Inc | Clinic/Center | 1610 Sheridan St, Hollywood, FL 33020-2306 | 2010-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629694203 | Oaks Medical Group, LLC | Internal Medicine | 2854 Jackson St, Hollywood, FL 33020 | 2020-06-19 |
| 1487217949 | Yaneisy Correa Vento Sr. | Nurse Practitioner | 2700 E Hollywood Blud, Hollywood, FL 33020 | 2019-04-19 |
| 1811453590 | Sandra's Car Service LLC | Non-emergency Medical Transport (VAN) | 2048 Mckinley St. Bay #1, Hollywood, FL 33020 | 2019-02-18 |
| 1134605330 | Cruz Ines Diaz | Peer Specialist | 3400 N- 29th Avenue, Hollywood, FL 33020 | 2018-07-11 |
| 1598258451 | Brian Tran | Dentist | 1704 Stirling Rd., Hollywood, FL 33020 | 2018-06-14 |
| 1295223451 | Broward Treatment Center | Substance Abuse Rehabilitation Facility | 1101 S 21 Ave, Hollywood, FL 33020 | 2018-04-24 |
| 1033617220 | Laura Goldman | Psychologist | 2514 Hollywood Blvd Ste 404, Hollywood, FL 33020 | 2018-01-23 |
| 1205344835 | Sunshine Health Supplies LLC | Durable Medical Equipment & Medical Supplies | 1926 Hollywood Blvd Ste 204, Hollywood, FL 33020 | 2018-01-17 |
| 1124536222 | Melina Rodriguez | Counselor | 3400 N 29th Avenue, Hollywood, FL 33020 | 2018-01-11 |
| 1003337783 | Publix Super Markers, Inc | Durable Medical Equipment & Medical Supplies | 1776 Polk St., Hollywood, FL 33020 | 2017-07-03 |
| Find all providers in zip 33020 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184232522 | Buen Pastor Medical Center, Inc. | General Practice | 4400 Sheridan St Ste C, Hollywood, FL 33021-3514 | 2020-07-22 |
| 1639734148 | Management Care LLC | General Practice | 7900 Nw 33rd St Ste 103, Hollywood, FL 33024-2209 | 2019-05-09 |
| 1730671504 | Rafael Torres | General Practice | 1915 Monroe St Apt 15, Hollywood, FL 33020-7700 | 2018-06-06 |
| 1003311051 | David Lee Arnold | General Practice | 1701 Fletcher St, Hollywood, FL 33020-6538 | 2018-03-29 |
| 1528468956 | Centro Medico Familiar Buen Pastor Pharmacy | General Practice | 4440 Sheridan St Ste C, Hollywood, FL 33021-3535 | 2014-09-04 |
| 1255741088 | Bonne Medical Center, Inc. | General Practice | 5928 Sheridan St Ste A, Hollywood, FL 33021 | 2014-05-01 |
| 1518388503 | Marc Joseph | General Practice | 2629 Funston St, Hollywood, FL 33020-5727 | 2013-12-18 |
| 1972871937 | Carevantage Medical Centers of Broward At Sterling Road,llc | General Practice | 2536 N State Road 7, Hollywood, FL 33021-3205 | 2011-12-06 |
| 1639379761 | Gabriel Gregorio Florez | General Practice | 4440 Sheridan St, Suite C, Hollywood, FL 33021 | 2007-07-18 |
| 1174697288 | William H Hayling | General Practice | 3301 Barham Blvd Ste 400, Hollywood, CA 90068-1477 | 2006-11-20 |
| Find all providers in HOLLYWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.