IndividualActive
Petra Wanzke, LMT, MMP
NPI 1174149603 · Massage Therapist · Orlando, FL
Provider details
- NPI number
- 1174149603
- Entity type
- Individual
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- LMT, MMP
- Sex
- Female
- Sole proprietor
- Yes
- License
- MA41903 (FL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3416 Keota Dr
Orlando, FL 32839-8722
Phone: (407) 307-4174
Street-level locationGet directions
Mailing address
3416 Keota Dr
Orlando, FL 32839-8722
Registry dates
- Enumerated
- 2020-06-20
- Last updated
- 2020-06-20
- Certified
- 2020-06-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.