Individual provider Active NPI

Renan Wolf, APRN

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1821960667
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11040285 Issued in FL
Practice address
6328 Gunn Hwy Ste B
Tampa, FL 33625-4101
Phone
(813) 964-8526
Fax
(813) 964-8536
NPI assigned
Sep 22, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 11040285 FL Primary

Addresses

Primary practice location

6328 Gunn Hwy Ste B
Tampa, FL 33625-4101

Mailing address

6328 Gunn Hwy Ste B
Tampa, FL 33625-4101
Phone (813) 964-8526

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL HIE Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260218000069 FL Practitioner - Nurse Practitioner 3678053618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6328 Gunn Hwy
Suite B
Tampa, FL 33625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11040285FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Citrus Park Medical Internal Medicine Current Accepting new patients
Citrus Park Medical Care Inc Single Specialty CurrentSince Dec 31, 2025 Accepting new patients

Locations

6328 Gunn Hwy
Ste B
Tampa, FL 33625
Phone (813) 964-8526

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1758499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1821960667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6328 GUNN HWY STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254101",
            "telephone_number": "813-964-8526",
            "fax_number": "813-964-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6328 GUNN HWY STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254101",
            "telephone_number": "813-964-8526",
            "fax_number": "813-964-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "RENAN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-22",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "11040285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HIE",
            "affiliation": "N",
            "endpointDescription": "emr",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6328 Gunn Hwy Ste B",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336254101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.