Individual
WILLIAM WAINWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1361 13TH AVE S STE 270, JACKSONVILLE BEACH, FL 32250-3258
(904) 241-7147
(904) 241-5492
Mailing address
PO BOX 43667, JACKSONVILLE, FL 32203-3667
(904) 720-0799
(904) 241-5492
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
31677
FL
207UN0901X
Nuclear Cardiology Physician
ME31677
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037979400
—
FL
01
—
110086219
RAILROAD MEDICARE
FL
Enumeration date
08/15/2005
Last updated
11/17/2015
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