Healthcare Provider Details

I. General information

NPI: 1467150748
Provider Name (Legal Business Name): JANAE WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 TURKEY LAKE RD STE 114
ORLANDO FL
32819-4205
US

IV. Provider business mailing address

6000 TURKEY LAKE RD STE 114
ORLANDO FL
32819-4205
US

V. Phone/Fax

Practice location:
  • Phone: 321-732-3723
  • Fax: 321-352-7168
Mailing address:
  • Phone: 321-732-3723
  • Fax: 321-352-7168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-256495
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number12103-M
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: