Active NPI
Edward Alan Wetzel
- Private Vehicle
- Orlando, FL
National Provider Identifier
1609053636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- 3100-0602419
- Practice address
- 612 S Dean Rd
Orlando, FL 32825-8100 - Phone
- (407) 306-9488
- Fax
- (407) 306-9487
- NPI assigned
- Jan 22, 2008
- Last updated
- Jan 22, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | 3100-0602419 | FL | Primary |
Addresses
Primary practice location
612 S Dean Rd
Orlando, FL 32825-8100
Mailing address
612 S Dean Rd
Orlando, FL 32825-8100
Phone (407) 306-9488
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 |
|---|---|---|---|
| 3100-0602419 | FL | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200960000000",
"number": "1609053636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 S DEAN RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328258100",
"telephone_number": "407-306-9488",
"fax_number": "407-306-9487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 S DEAN RD",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328258100",
"telephone_number": "407-306-9488",
"fax_number": "407-306-9487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WETZEL",
"first_name": "EDWARD",
"middle_name": "ALAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-22",
"last_updated": "2008-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "FL",
"license": "3100-0602419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.