Individual
MR. KENNETH J WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
2809 W WATERS AVE, TAMPA, FL 33614-1852
(813) 348-9088
(813) 348-9310
Mailing address
2809 W WATERS AVE, TAMPA, FL 33614-1852
(813) 348-9088
(813) 348-9310
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
29517
AL
2086S0129X
Vascular Surgery Physician
Primary
ME105164
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002462600
—
FL
01
—
ME15684
LICENSE
FL
Enumeration date
05/04/2006
Last updated
03/08/2011
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