MEDICARE: DR. STEVEN WAYNE WRIGHT D.O.

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	207Q00000X	Family Medicine Physician	OS4636	FL

General Provider Information

NPI Number	:	1477622066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN WAYNE WRIGHT D.O.

Provider Business Mailing Address
First Line	:	1452 BELLAIRE LANE NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905
Country	:	US
Telephone Number	:	321-676-5151
Fax Number	:	321-676-5165

Provider Business Practice Location Address
First Line	:	1452 BELLAIRE LANE NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905
Country	:	US
Telephone Number	:	321-676-5151
Fax Number	:	321-676-5165

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/25/2010

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