MEDICARE: MS. ELIZABETH ANNE WRIGHT MPT

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
1	225100000X	Physical Therapist	23007	FL

General Provider Information

NPI Number	:	1245365709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH ANNE WRIGHT MPT

Provider Business Mailing Address
First Line	:	18941 PORTOFINO DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3409
Country	:	US
Telephone Number	:	214-335-6103
Fax Number	:

Provider Business Practice Location Address
First Line	:	5503 E FOWLER AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-2225
Country	:	US
Telephone Number	:	813-983-0440
Fax Number	:	813-983-8110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	07/08/2007

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