MEDICARE: WESLEY E GRIFFITT MD

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	207T00000X	Neurological Surgery Physician	ME142989	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	M6560	OTHER	FL	MEDICARE HFPSI
3	MC231	OTHER	FL	MEDICARE

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
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821002684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WESLEY E GRIFFITT MD

Provider Business Mailing Address
First Line	:	3300 S FISKE BLVD
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-4306
Country	:	US
Telephone Number	:	321-434-3420
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251 HICKORY ST
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-3221
Country	:	US
Telephone Number	:	321-434-3420
Fax Number	:	321-434-3423

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	11/18/2020

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Directions to “ WESLEY E GRIFFITT MD” Practice Location

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