Timothy Ray Walendzik, LMT

Primary specialty

ContractorTaxonomy code 171W00000X

License

MA 47444 Issued in FL

Practice address

13911 Lakeshore Blvd
Unit 102
Hudson, FL 34667-7102

Phone

(727) 869-3803

NPI assigned

Jan 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Massage & Therapy Inc.

  • Specialist
  • Hudson, FL
  • NPI 1114078649
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114078961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1248 JASMINE LAKE DR",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346895264",
            "telephone_number": "727-934-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13911 LAKESHORE BLVD",
            "address_2": "UNIT 102",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677102",
            "telephone_number": "727-869-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALENDZIK",
        "first_name": "TIMOTHY",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "FL",
            "license": "MA 47444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hector Vydas
• Michael J Wahl, M.D.
• Rachel Marie Waite, RN
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5266)
• Wal-Mart Stores East, LP (Walmart Vision Center 30-5266)
• Walgreen Co (Walgreens #04400)
• Walgreen Co (Walgreens #03629)
• Walgreen Co (Walgreens #07466)
• Walgreens
• John P. Walker, D.M.D.

• Contractor in Hudson, FL
• Providers in Hudson, FL by specialty
• Contractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.