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Jaquenetta Williams Bennertt, PT

NPI 1679073852ActiveIndividual· Physical Therapist· Lake Wales, FL

Physical Therapist (PT) in Lake Wales, Florida, with an NPI issued in February 2018.

Overview

NPI1679073852
StatusActive
Entity typeIndividual
CredentialPT
Sole proprietorNo
NPI issuedFeb 14, 2018
Last updated in NPPESFeb 14, 2018

Specialties and licenses

TaxonomyCodeLicenseState
Physical Therapist Primary225100000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

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