Provider Demographics
NPI:1861798944
Name:WRIGHT, ZACHARY (MD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W GORE ST STE 403
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1049
Mailing Address - Country:US
Mailing Address - Phone:321-841-3050
Mailing Address - Fax:321-843-3570
Practice Address - Street 1:100 W GORE ST STE 403
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1049
Practice Address - Country:US
Practice Address - Phone:321-841-3050
Practice Address - Fax:321-843-3570
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL34520207T00000X
CAA155607207T00000X
FLME165700207T00000X
AL35846207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL120733600Medicaid