Provider Demographics
NPI:1841211505
Name:TRENSCHEL, WALTER ROBERT (PHD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:ROBERT
Last Name:TRENSCHEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 NORTH OCEAN BLVD
Mailing Address - Street 2:LEXINGTON #101
Mailing Address - City:OCEAN RIDGE
Mailing Address - State:FL
Mailing Address - Zip Code:33435
Mailing Address - Country:US
Mailing Address - Phone:561-732-0123
Mailing Address - Fax:561-732-0123
Practice Address - Street 1:5505 NORTH OCEAN BLVD
Practice Address - Street 2:LEXINGTON #101
Practice Address - City:OCEAN RIDGE
Practice Address - State:FL
Practice Address - Zip Code:33435
Practice Address - Country:US
Practice Address - Phone:561-732-0123
Practice Address - Fax:561-732-0123
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0004569103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73913OtherBCBS
FL73913OtherBCBS