Provider Demographics
NPI:1194366609
Name:WRIGHT, GARY FRANCIS JR (NP-C)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:FRANCIS
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 PALMWAY ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4542
Mailing Address - Country:US
Mailing Address - Phone:407-931-3700
Mailing Address - Fax:407-567-7900
Practice Address - Street 1:8927 CONROY WINDERMERE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835
Practice Address - Country:US
Practice Address - Phone:407-395-4473
Practice Address - Fax:407-567-7900
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-06
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004247363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner