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NPI Code Detail

MEDICARE: MRS. ELIZABETH ANNE WENZEL LPTA

MEDICARE: MRS. ELIZABETH ANNE WENZEL LPTA
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
1225200000XPhysical Therapy AssistantPTA19066FL

General Provider Information

NPI Number : 1598959017
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH ANNE WENZEL LPTA
Provider Business Mailing Address
First Line : 13072 QUINCY BAY DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32224-7412
Country : US
Telephone Number : 904-992-4550
Fax Number : 904-448-8855
Provider Business Practice Location Address
First Line : 8855 SAN JOSE BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-4244
Country : US
Telephone Number : 904-448-8191
Fax Number : 904-448-8855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2007
Last Update Date : 08/28/2007

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Directions to “ MRS. ELIZABETH ANNE WENZEL LPTA” Practice Location

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