Laurence T Wylie

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME33987 Issued in FL

Practice address

3950 Tiger Bay Rd
Daytona Beach, FL 32124-1042

Phone

(386) 290-9329

NPI assigned

Nov 19, 2013

Last updated

Nov 19, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384819200000",
    "number": "1568892099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 TIGER BAY RD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321241042",
            "telephone_number": "386-290-9329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 TIGER BAY RD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321241042",
            "telephone_number": "386-290-9329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "LAURENCE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-19",
        "last_updated": "2013-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME33987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wulff Medical Inc
• Kristin L Wulff, MD
• Jimmy Allen Wyatt, PA-C
• Sharniece Wyatt
• Alik Wyche
• Cheryl J Wynn, DPT
• Julianne M Wysocki Broadwater, D.O.
• Yifan Xing
• Katerina Xu, PHARMD
• Donna C Xynidis, MS, SLP

• Psychiatry Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.