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General NPI Number Information
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NPI Number | 1417699539
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Entity Type | Individual
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Provider Name | JERVON A WRIGHT MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 04/09/2022
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 703 N FLAMINGO ROAD GRADUATE MEDICAL EDUCATION, 2ND FLOOR
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-3876
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Country | US
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Telephone | 954-265-4463
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Fax |
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Provider Business Mailing Address
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Address Line | 703 N FLAMINGO ROAD GRADUATE MEDICAL EDUCATION, 2ND FLOOR
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City | MANHASSET
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State | FL
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Zip | 33028-1006
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Country | US
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Telephone | 954-265-4463
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | TRN41842
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License Number State | FL
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