Healthcare Provider Details

I. General information

NPI: 1851328629
Provider Name (Legal Business Name): SONDRA WHEELER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SONDRA J MOHRMAN PA-C

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 S MARION AVE
LAKE CITY FL
32025-5808
US

IV. Provider business mailing address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

V. Phone/Fax

Practice location:
  • Phone: 386-755-3016
  • Fax:
Mailing address:
  • Phone: 352-548-6000
  • Fax: 352-374-6103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9100883
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: