Provider Demographics
NPI:1366198434
Name:WRIGHT, WESLEY (RPH)
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10112 GREEN BRANCH CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-8565
Mailing Address - Country:US
Mailing Address - Phone:954-682-7629
Mailing Address - Fax:
Practice Address - Street 1:2420 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5019
Practice Address - Country:US
Practice Address - Phone:407-894-6781
Practice Address - Fax:407-894-9457
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60053183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist