Provider Demographics
NPI:1134550288
Name:CAMYSHA WRIGHT MD PA
Entity type:Organization
Organization Name:CAMYSHA WRIGHT MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMYSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-368-8519
Mailing Address - Street 1:201 NW 82 AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1856
Mailing Address - Country:US
Mailing Address - Phone:954-368-8519
Mailing Address - Fax:954-716-6551
Practice Address - Street 1:201 NW 82ND AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1856
Practice Address - Country:US
Practice Address - Phone:954-368-8519
Practice Address - Fax:954-716-6551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-27
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME104723207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty