Individual
JEFFERY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
133 BENMORE DR STE 100, WINTER PARK, FL 32792-4111
(407) 644-4883
(407) 644-3697
Mailing address
133 BENMORE DR STE 100, WINTER PARK, FL 32792-4111
(407) 644-4883
(407) 644-3697
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9108029
FL
Other
Enumeration date
08/03/2014
Last updated
07/21/2022
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