Lisa Wieczorek, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA 21717 Issued in FL

Practice address

17604 90TH St N
Loxahatchee, FL 33470-2631

Phone

(561) 602-9990

Fax

(561) 333-5939

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1235249673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17604 90TH ST N",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334702631",
            "telephone_number": "561-602-9990",
            "fax_number": "561-333-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17604 90TH ST N",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334702631",
            "telephone_number": "561-602-9990",
            "fax_number": "561-333-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIECZOREK",
        "first_name": "LISA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA 21717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "677392396",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Loxahatchee, FL
• Providers in Loxahatchee, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.