MEDICARE: ERIK WENZEL

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	111N00000X	Chiropractor	CH11146	FL

General Provider Information

NPI Number	:	1124447669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIK WENZEL

Provider Business Mailing Address
First Line	:	425 ALEXANDRIA BLVD
Second Line	:	STE 1010
City	:	OVIEDO
State	:	FL
Zip	:	32765-5548
Country	:	US
Telephone Number	:	407-977-3434
Fax Number	:	407-977-3433

Provider Business Practice Location Address
First Line	:	425 ALEXANDRIA BLVD
Second Line	:	STE 1010
City	:	OVIEDO
State	:	FL
Zip	:	32765-5548
Country	:	US
Telephone Number	:	407-977-3434
Fax Number	:	407-977-3433

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

Provider Enumeration Date	:	04/14/2014
Last Update Date	:	04/14/2014

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Directions to “ ERIK WENZEL ” Practice Location

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