Healthcare Provider Details

I. General information

NPI: 1073478103
Provider Name (Legal Business Name): WENDY L. BEFFERT LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9813 MAR LARGO CIR
FORT MYERS FL
33919-7340
US

IV. Provider business mailing address

9813 MAR LARGO CIR
FORT MYERS FL
33919-7340
US

V. Phone/Fax

Practice location:
  • Phone: 908-578-9811
  • Fax:
Mailing address:
  • Phone: 908-578-9811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA100278
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: