Suzanne Margaret Wynn, L.M.T.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA0017044 Issued in FL

Practice address

606 NW 32ND PL
Gainesville, FL 32609-2228

Phone

(352) 214-7768

Fax

(352) 380-9804

NPI assigned

Nov 24, 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 2

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": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710053632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 NW 32ND PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326092228",
            "telephone_number": "352-214-7768",
            "fax_number": "352-380-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 NW 32ND PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326092228",
            "telephone_number": "352-214-7768",
            "fax_number": "352-380-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "SUZANNE",
        "middle_name": "MARGARET",
        "name_prefix": "Miss",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA0017044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE NUMBER",
            "identifier": "MA0017044",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "C6051",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Cole Wymer, MD
• James P Wymer, MD
• Cynthia Wynn-Graves
• Jaclyn Wynn, PA-C
• James Lawrence Wynn, M.D.
• Tung T Wynn, M.D.
• James W. Wynne, MD
• Latanya Faye Wynnhall
• Wynter ABA Therapy Services, LLC
• Sonji Xavier-Borden, RN, MSN, CNOR, FNP-C

• Specialist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Specialist 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.