Provider Demographics
NPI:1326116526
Name:WEEKS, WENDY (LMT)
Entity Type:Individual
Prefix:MISS
First Name:WENDY
Middle Name:
Last Name:WEEKS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:WENDY
Other - Middle Name:WEEKS
Other - Last Name:RESTINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8047 BIRMAN ST
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751
Mailing Address - Country:US
Mailing Address - Phone:407-661-1934
Mailing Address - Fax:407-661-1301
Practice Address - Street 1:2711 STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779
Practice Address - Country:US
Practice Address - Phone:407-774-3311
Practice Address - Fax:407-774-4146
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0016125225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC6209OtherBCBS