Provider Demographics
NPI:1972253961
Name:WRIGHT, REBECCA RIEGEL
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:RIEGEL
Last Name:WRIGHT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15932 E HIGHWAY 40
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34488-5144
Mailing Address - Country:US
Mailing Address - Phone:352-625-7777
Mailing Address - Fax:352-625-1970
Practice Address - Street 1:15932 E HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34488-5144
Practice Address - Country:US
Practice Address - Phone:352-625-7777
Practice Address - Fax:352-625-1970
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME172445207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL125904200Medicaid