Provider Demographics
NPI:1215118294
Name:WALTER TRENSCHEL, PH.D.
Entity type:Organization
Organization Name:WALTER TRENSCHEL, PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:
Authorized Official - Last Name:DILEONARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-321-1980
Mailing Address - Street 1:5505 N OCEAN BLVD
Mailing Address - Street 2:LEXINGTON 101
Mailing Address - City:OCEAN RIDGE
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7086
Mailing Address - Country:US
Mailing Address - Phone:561-706-3426
Mailing Address - Fax:
Practice Address - Street 1:5505 N OCEAN BLVD
Practice Address - Street 2:LEXINGTON 101
Practice Address - City:OCEAN RIDGE
Practice Address - State:FL
Practice Address - Zip Code:33435-7086
Practice Address - Country:US
Practice Address - Phone:561-706-3426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4569103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty