MEDICARE: RACHEL NICHOLE WENTZ

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	2355S0801X	Speech-Language Assistant	SI7352	FL

General Provider Information

NPI Number	:	1518765569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL NICHOLE WENTZ

Provider Business Mailing Address
First Line	:	1800 MICOSUKE CMNS DR APT 1317
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5440
Country	:	US
Telephone Number	:	727-580-5850
Fax Number	:

Provider Business Practice Location Address
First Line	:	2937 KERRY FOREST PKWY STE B1
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-7800
Country	:	US
Telephone Number	:	850-890-4852
Fax Number	:

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

Provider Enumeration Date	:	03/05/2025
Last Update Date	:	03/05/2025

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Directions to “ RACHEL NICHOLE WENTZ ” Practice Location

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