| Doctor Name: | MR. RAYMOND F WENCK |
| NPI Number: | 1659445302 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | BC-HIS |
| License Number: | AS2799 |
| Business Practice Address: | 2866 Tamiami Trl Suite D Port Charlotte, FL - 339525126 |
| Business Phone Number: | 9412550038 |
| Business Fax Number: | 9412550728 |
| Mailing Address: | 2510 E Sunset Rd, Unit 5-260 LAS VEGAS |
| State: | NV |
| Postal Code: | 891203511 |
| Phone Number: | 7027980113 |
| Fax Number: | 8662915242 |
| NPI Enumeration Date: | 11/17/2006 |
| NPI Last Update Date: | 12/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | AS2799 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |