Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT14616 | FL |
N | 2251C2600X | Cardiopulmonary | PT14616 | FL |
N | 2251E1200X | Ergonomics | PT14616 | FL |
N | 225XE1200X | Ergonomics | PT14616 | FL |
N | 2251G0304X | Physical Therapist - Geriatrics | PT14616 | |
N | 2251N0400X | Physical Therapist - Neurology | PT14616 | FL |
N | 2251S0007X | Physical Therapist - Sports | PT14616 | FL |
N | 2251X0800X | Physical Therapist - Orthopedic | PT14616 | FL |
NPI | 1962661116 |
---|---|
Provider Name | Dr. Johannes Helmert Wijnmaalen |
First Address | Odessa, FL 33556-3445 |
Second Address | Odessa, FL 33556-3445 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 19/05/2010 |