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NPI Code Detail

MEDICARE: SAVANNAH WRYE

MEDICARE: SAVANNAH WRYE
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
1363AM0700XMedical Physician AssistantFL

General Provider Information

NPI Number : 1023708112
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNAH WRYE
Provider Business Mailing Address
First Line : 660 CYPRESS GREEN CIR
Second Line :
City : WELLINGTON
State : FL
Zip : 33414-6335
Country : US
Telephone Number : 561-601-9174
Fax Number :
Provider Business Practice Location Address
First Line : 7031 WASHINGTON AVE
Second Line :
City : LANTANA
State : FL
Zip : 33462-5201
Country : US
Telephone Number : 561-585-2550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2023
Last Update Date : 01/16/2024

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Directions to “ SAVANNAH WRYE ” Practice Location

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