Provider Demographics
NPI:1578512240
Name:WRIGHT, HEATHER R (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:1150 N 35TH AVE STE 170
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5424
Practice Address - Country:US
Practice Address - Phone:954-265-4325
Practice Address - Fax:954-985-2451
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2021-03-22
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Provider Licenses
StateLicense IDTaxonomies
FLME1220452086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014030300Medicaid
I25170Medicare UPIN
KY64105885Medicaid