Individual provider Active NPI

Mark Manley Zwingelberg, PSY.D.

  • Clinical Psychologist
  • Winter Haven, FL
National Provider Identifier
1356409783
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 3630 Issued in FL
Practice address
3425 Lake Alfred Road
Winter Haven Hospital Rehabilitation Services
Winter Haven, FL 33881
Phone
(863) 292-4061
Fax
(863) 293-6985
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY 3630 FL
Clinical Psychologist 103TC0700X PY 3630 FL Primary

Addresses

Primary practice location

3425 Lake Alfred Road
Winter Haven Hospital Rehabilitation Services
Winter Haven, FL 33881

Mailing address

4503 Brandywood Place
Lakeland, FL 33801
Phone (863) 666-3838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY 3630FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Winter Haven Hospital Inc PastSince Nov 24, 2019 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1356409783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4503 BRANDYWOOD PLACE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33801",
            "telephone_number": "863-666-3838",
            "fax_number": "863-666-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 LAKE ALFRED ROAD",
            "address_2": "WINTER HAVEN HOSPITAL REHABILITATION SERVICES",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "33881",
            "telephone_number": "863-292-4061",
            "fax_number": "863-293-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWINGELBERG",
        "first_name": "MARK",
        "middle_name": "MANLEY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY 3630",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 3630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.