MEDICARE: RANDY JAMES WUNSCHE OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT8999	FL

General Provider Information

NPI Number	:	1073481529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDY JAMES WUNSCHE OT

Provider Business Mailing Address
First Line	:	6390 HIGH POINTE WEST WAY
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-5433
Country	:	US
Telephone Number	:	772-633-2719
Fax Number	:

Provider Business Practice Location Address
First Line	:	2180 10TH AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5399
Country	:	US
Telephone Number	:	772-633-2719
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2025
Last Update Date	:	10/27/2025

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