MEDICARE: MS. SHAKIERA WRIGHT RRT

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	227900000X	Registered Respiratory Therapist	RT11370	FL

General Provider Information

NPI Number	:	1710256862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHAKIERA WRIGHT RRT

Provider Business Mailing Address
First Line	:	465 SW 20TH AVE APT 19
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-7671
Country	:	US
Telephone Number	:	954-934-3861
Fax Number	:

Provider Business Practice Location Address
First Line	:	465 SW 20TH AVE APT 19
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-7671
Country	:	US
Telephone Number	:	954-934-3861
Fax Number	:

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

Provider Enumeration Date	:	12/19/2011
Last Update Date	:	12/19/2011

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