Male or Other

Mr. Michael D. Wendt PA

Physician Assistant in Jacksonville, FL(View on Map)

Full Name

Mr. Michael Darren Wendt PA

NPI Number

1609173236

NPI Type

Individual Provider

Gender

Male

Enumeration Date

02/17/2011

Specialties

(Taxonomies)

Code

363A00000X
363AM0700X

Primary Taxonomy

Yes
No

Licenses

State

Florida

License Number

PA9112985

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 878
6545 NORMANDY BLVD

City

Davenport
Jacksonville

State

FL
FL

Postal Code

33836-0878
32205-6201

Country

US
US

Telephone Number

(689) 698-3720
(904) 861-1901

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/27/2024

Provider Address

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