Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack J Wilson MD PA

Organization Obstetrics & Gynecology Physician · NPI 1083644025

Jack J Wilson MD PA is an Obstetrics & Gynecology Physician in Winter Park, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2025 Summerland Ave
Winter Park, FL 32789-1453
Phone: (407) 628-0853
Fax: (407) 628-0853
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence ME 0058840 (FL)

Record details

NPI number1083644025
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jack Wilson — Pres · (407) 628-0853
NPI enumeratedJuly 4, 2006
Last updated in NPPESJune 7, 2010
Mailing address2025 Summerland Ave, Winter Park, FL 32789-1453

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