MEDICARE: BRYAN P WU M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	ME178494	FL

General Provider Information

NPI Number	:	1043339294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYAN P WU M.D.

Provider Business Mailing Address
First Line	:	1611 NW 12TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1005
Country	:	US
Telephone Number	:	305-243-5422
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 S DIXIE HWY
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-2926
Country	:	US
Telephone Number	:	305-243-9462
Fax Number	:

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	04/06/2026

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