PETRA E WANZKE (NPI# 1174149603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174149603 |
| Entity Type | Individual |
| Full Name | PETRA E WANZKE |
| Credential | LMT, MMP |
| Practice Address |
3416 Keota Dr Orlando FL 32839-8722 |
| Practice Telephone | 4073074174 |
| Mailing Telephone | 4073074174 |
| Enumeration Date | 2020-06-20 |
| Last Update Date | 2020-06-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA41903 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3416 KEOTA DR |
| City | ORLANDO |
| State | FL |
| Zip Code | 32839-8722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851916951 | Good Ole Days Adult Living Facility LLC | Assisted Living Facility | 3913 Trovati Street, Orlando, FL 32839 | 2020-06-15 |
| 1396399846 | Steven Outlaw | Specialist/Technologist | 216 Spencer St, Orlando, FL 32839 | 2019-08-01 |
| 1225517279 | Orlando Outpatient Surgery Center LLC | Clinic/Center | 1736 33rd St, Orlando, FL 32839 | 2018-08-10 |
| 1811406564 | Latonya Rouse | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5214 Via Hacienda, 206, Orlando, FL 32839 | 2017-09-26 |
| 1154841153 | Jillisa Clobree Tarver | Technician, Other | 5451 Millenia Lakes Blvd Apt 186, Orlando, FL 32839 | 2017-06-21 |
| 1760917728 | Beatriz Baez | Health Educator | 4836 Ligustrom Way, Orlando, FL 32839 | 2017-04-27 |
| 1740637115 | Marines Vigo | Psychologist | 1114 Redman St, Apt B, Orlando, FL 32839 | 2016-05-16 |
| 1417332560 | Kimona Lawrence | Optometrist | 4200 Conroy Road, Orlando, FL 32839 | 2015-07-29 |
| 1942627732 | Jennifer Lombardo | Social Worker | 4530 S Orange Blossom Trl # 570, Orlando, FL 32839 | 2014-03-18 |
| 1336413863 | Cheryl Lynn Anderson | Social Worker | 3805 Millenia Blvd, #110, Orlando, FL 32839 | 2012-03-01 |
| Find all providers in zip 32839 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538768049 | Desiree Monique Bethelmie | Massage Therapist | 1608 S Crystal Lake Dr Apt 54, Orlando, FL 32806-3358 | 2020-10-26 |
| 1467051599 | Masae Shimomoto | Massage Therapist | 7422 Radiant Cir, Orlando, FL 32810-3136 | 2020-10-20 |
| 1760080352 | Amanda Lea Gill | Massage Therapist | 3829 Albright Ln, Orlando, FL 32828-6468 | 2020-10-15 |
| 1568060788 | Enoch Leacock | Massage Therapist | 6900 S Orange Blossom Trl Ste 304, Orlando, FL 32809-5736 | 2020-10-09 |
| 1073110466 | Brenden Kuhn | Massage Therapist | 1324 Lake Baldwin Ln Apt B, Orlando, FL 32814-6665 | 2020-10-08 |
| 1013514462 | Sylvia Michelle Burch | Massage Therapist | 1800 Curry Ford Rd, Orlando, FL 32806-2416 | 2020-10-07 |
| 1154928083 | Angelica Inez Jusino | Massage Therapist | 514 Hillcrest St Apt B, Orlando, FL 32803-4505 | 2020-10-05 |
| 1255948097 | Aubrey F Soloven | Massage Therapist | 5635 Marinell Dr, Orlando, FL 32809-4245 | 2020-09-25 |
| 1265049373 | Jessy Kimbrell | Massage Therapist | 5967 Folkstone Ln, Orlando, FL 32822-9420 | 2020-09-23 |
| 1790390516 | Sally E Moon | Massage Therapist | 10216 Kensington Shore Dr, Orlando, FL 32827-7306 | 2020-09-09 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.