JACK J WILSON MD PA
Medical Practice at Summerland Ave, Winter Park, FL

License number
Florida ME 0058840
Category
Medical Practice
Type
Obstetrics & Gynecology
Owner
Name: DR. JACK J WILSON MD
Title: PRES
Phone: (407) 628-0853
Address
Address
2025 Summerland Ave, Winter Park, FL 32789
National Provider ID: 1083644025
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Jack J. Wilson, M.D., PA

Maitland, FL  -  Winter Park, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Registration:
Jun 24, 1998
Addresses:
301 S Maitland Ave, Maitland, FL 32751
2025 Summerland Ave, Winter Park, FL 32789
State ID:
P98000058305
Business type:
Domestic for Profit Corporation
President, Treasurer, Secretary, Vice President:
Jack J. Wilson President, Treasurer, Secretary, Vice President, inactive

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