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NPI Code Detail

MEDICARE: WUESTHOFF EMERGENCY PHYSICIANS-MELBOURNE PA

MEDICARE: WUESTHOFF EMERGENCY PHYSICIANS-MELBOURNE PA
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
1207P00000XEmergency Medicine PhysicianFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
134457OTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508868886
Entity Type Code : Organization
Provider Name (Legal Business Name) : WUESTHOFF EMERGENCY PHYSICIANS-MELBOURNE PA
Provider Business Mailing Address
First Line : PO BOX 552205
Second Line :
City : TAMPA
State : FL
Zip : 33655-0001
Country : US
Telephone Number : 800-476-8646
Fax Number : 919-382-3210
Provider Business Practice Location Address
First Line : 250 N WICKHAM RD
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-8625
Country : US
Telephone Number : 800-476-8646
Fax Number : 919-382-3210
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. CURRIN NICHOL
Credential : MD
Telephone Number : 800-476-8646
Provider Enumeration Date : 06/01/2005
Last Update Date : 07/21/2022

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Directions to “WUESTHOFF EMERGENCY PHYSICIANS-MELBOURNE PA ” Practice Location

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