MEDICARE: WENDY OLIVER-PYATT 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	103TP0016X	Prescribing (Medical) Psychologist	8446NV	NV
2	2084P0800X	Psychiatry Physician	193619	NY
3	2084P0800X	Psychiatry Physician	8446NV	NV
4	2084P0800X	Psychiatry Physician	ME100796	FL

General Provider Information

NPI Number	:	1336339274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY OLIVER-PYATT M.D.

Provider Business Mailing Address
First Line	:	6011 SW 82ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-8127
Country	:	US
Telephone Number	:	305-240-9903
Fax Number	:	786-216-7015

Provider Business Practice Location Address
First Line	:	6011 SW 82ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33143-8127
Country	:	US
Telephone Number	:	305-240-9903
Fax Number	:	786-216-7015

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

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	07/26/2021

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