MEDICARE: ANNE 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	225100000X	Physical Therapist	8901	FL

General Provider Information

NPI Number	:	1821670738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE WENTZ

Provider Business Mailing Address
First Line	:	1940 WOODBRIDGE DR
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32514-5747
Country	:	US
Telephone Number	:	850-516-6180
Fax Number	:

Provider Business Practice Location Address
First Line	:	7830 PINE FOREST RD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32526-8404
Country	:	US
Telephone Number	:	850-941-5000
Fax Number	:

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

Provider Enumeration Date	:	04/21/2021
Last Update Date	:	04/21/2021

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Directions to “ ANNE WENTZ ” Practice Location

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