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NPI Code Detail

MEDICARE: JULIETA M WENK

MEDICARE: JULIETA M WENK
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
1101YM0800XMental Health CounselorMH15533FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164936373
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIETA M WENK
Provider Business Mailing Address
First Line : 11084 RIVER TRENT CT
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33971-3741
Country : US
Telephone Number : 239-826-8046
Fax Number :
Provider Business Practice Location Address
First Line : 12811 KENWOOD LN STE 213
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-5648
Country : US
Telephone Number : 239-537-9646
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2017
Last Update Date : 05/04/2022

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