Active NPI
Mark Wimberley, DPT
- Physical Therapist
- Winter Park, FL
National Provider Identifier
1366385643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT40225
- Practice address
- 2005 Mizell Ave # 2400
Winter Park, FL 32792-4126 - Phone
- (407) 646-7703
- NPI assigned
- Apr 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT40225 | FL | Primary |
Addresses
Primary practice location
2005 Mizell Ave # 2400
Winter Park, FL 32792-4126
Mailing address
2005 Lake Baldwin LN Unit 202
Orlando, FL 32814-6931
Phone (954) 734-4240
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT40225 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776038400000",
"number": "1366385643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 LAKE BALDWIN LN UNIT 202",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328146931",
"telephone_number": "954-734-4240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2005 MIZELL AVE # 2400",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327924126",
"telephone_number": "407-646-7703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIMBERLEY",
"first_name": "MARK",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-13",
"last_updated": "2026-04-13",
"certification_date": "2026-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT40225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.