MEDICARE: MR. STEPHEN ROBERT WRIGHT P.A-C

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	363A00000X	Physician Assistant	PA9101688	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528180635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN ROBERT WRIGHT P.A-C

Provider Business Mailing Address
First Line	:	7951 NW 13TH ST
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-5112
Country	:	US
Telephone Number	:	954-985-9564
Fax Number	:

Provider Business Practice Location Address
First Line	:	10025 CLEARY BLVD
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-1000
Country	:	US
Telephone Number	:	954-382-1550
Fax Number	:	954-382-1250

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	07/08/2007

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