Provider Demographics
NPI:1912193962
Name:WISHINSKY, FRANK MICHAEL (LMT)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:MICHAEL
Last Name:WISHINSKY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 401
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34673-0401
Mailing Address - Country:US
Mailing Address - Phone:727-389-1280
Mailing Address - Fax:
Practice Address - Street 1:8253 MEDFORD DR
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-4225
Practice Address - Country:US
Practice Address - Phone:727-389-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-23
Last Update Date:2007-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA25194225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist