Individual provider Active NPI

Wencester Dean Rosiana Canal, PT

  • Physical Therapist
  • Lady Lake, FL
National Provider Identifier
1861686149
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT12214 Issued in FL
Practice address
134 N Old Dixie Hwy
Lady Lake, FL 32159-4347
Phone
(352) 751-6627
NPI assigned
Aug 30, 2007
Last updated
Aug 30, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT12214 FL Primary

Addresses

Primary practice location

134 N Old Dixie Hwy
Lady Lake, FL 32159-4347

Mailing address

2216 Aitkin Loop
Leesburg, FL 34748-2963
Phone (352) 751-6627

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

Practice roles

OrganizationSpecialtyStatusNew patients
Leesburg Rehabilitation Specialists Physical Therapist Past Accepting new patients
Lakeview Occupational and Industrial Clinic Dba a Plus Occupational an Past Accepting new patients
FL Rehab Services LLC Physical Therapist PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188432000000",
    "number": "1861686149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 AITKIN LOOP",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347482963",
            "telephone_number": "352-751-6627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 N OLD DIXIE HWY",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321594347",
            "telephone_number": "352-751-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAL",
        "first_name": "WENCESTER",
        "middle_name": "DEAN ROSIANA",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT12214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.