Healthcare Provider Details

I. General information

NPI: 1255682316
Provider Name (Legal Business Name): WENDY B FRAME
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2012
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1128 W PRINCETON ST
ORLANDO FL
32804-5249
US

IV. Provider business mailing address

1128 W PRINCETON STREET
ORLANDO FL
32804-5249
US

V. Phone/Fax

Practice location:
  • Phone: 760-525-9556
  • Fax:
Mailing address:
  • Phone: 760-525-9556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberOT 60258666
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: