MEDICARE: DR. DANA WRIGHT PHARM.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	183500000X	Pharmacist	PS35998	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PS35998	OTHER	FL	FL LICENSE NUMBER

General Provider Information

NPI Number	:	1629358361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANA WRIGHT PHARM.D.

Provider Business Mailing Address
First Line	:	2251 N SEMORAN BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-3707
Country	:	US
Telephone Number	:	407-702-1154
Fax Number	:	407-657-5098

Provider Business Practice Location Address
First Line	:	2251 N SEMORAN BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32807-3707
Country	:	US
Telephone Number	:	407-702-1154
Fax Number	:	407-657-5098

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

Provider Enumeration Date	:	08/25/2011
Last Update Date	:	08/25/2011

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