Provider Demographics
NPI:1184038390
Name:WRIGHT, SHEREE (OD)
Entity Type:Individual
Prefix:
First Name:SHEREE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 LITHIA PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-5636
Mailing Address - Country:US
Mailing Address - Phone:951-452-6616
Mailing Address - Fax:
Practice Address - Street 1:2223 N WEST SHORE BLVD
Practice Address - Street 2:202
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1411
Practice Address - Country:US
Practice Address - Phone:813-350-0870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 005097152W00000X
NY008187152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist