MEDICARE: DR. ALLEN WENDT M.D.

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	208000000X	Pediatrics Physician	036-108401	IL
2	208000000X	Pediatrics Physician	C53816	CA
3	208000000X	Pediatrics Physician	ME117593	FL

General Provider Information

NPI Number	:	1194793976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN WENDT M.D.

Provider Business Mailing Address
First Line	:	900 S PINE ISLAND RD
Second Line	:	SUITE 800
City	:	PLANTATION
State	:	FL
Zip	:	33324-3920
Country	:	US
Telephone Number	:	561-733-4400
Fax Number	:	561-733-5004

Provider Business Practice Location Address
First Line	:	10301 HAGEN RANCH RD
Second Line	:	BLDG A, SUITE 760
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3724
Country	:	US
Telephone Number	:	561-733-4400
Fax Number	:	561-733-5004

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	03/17/2014

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Directions to “ DR. ALLEN WENDT M.D.” Practice Location

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