Healthcare Provider Details

I. General information

NPI: 1265537476
Provider Name (Legal Business Name): JAY N WRIGHT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 BOREN DR
OCOEE FL
34761-2989
US

IV. Provider business mailing address

1555 BOREN DR
OCOEE FL
34761-2989
US

V. Phone/Fax

Practice location:
  • Phone: 407-292-2156
  • Fax: 407-241-2868
Mailing address:
  • Phone: 407-292-2156
  • Fax: 407-241-2868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME83362
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberME83362
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: