MEDICARE: FARRAH I WRIGHT APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11019115	FL

General Provider Information

NPI Number	:	1417699752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARRAH I WRIGHT APRN

Provider Business Mailing Address
First Line	:	18640 NW 2ND AVE # 5420
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-4508
Country	:	US
Telephone Number	:	954-247-8739
Fax Number	:

Provider Business Practice Location Address
First Line	:	18640 NW 2ND AVE # 5420
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-4508
Country	:	US
Telephone Number	:	954-247-8739
Fax Number	:

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

Provider Enumeration Date	:	04/08/2022
Last Update Date	:	03/07/2025

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