Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Kenneth Wayne Waldburg Jr.

Individual provider Massage Therapist · NPI 1316712698

Mr. Kenneth Wayne Waldburg Jr. is a Massage Therapist in Jacksonville, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2023
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Practice location Address checks out

4629 Gerber Ct
Jacksonville, FL 32210-1411
Phone: (904) 790-3671
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence MA62122 (FL)

Record details

NPI number1316712698
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 16, 2023
Last updated in NPPESNovember 16, 2023
Certification dateNovember 16, 2023

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