Healthcare Provider Details

I. General information

NPI: 1164469326
Provider Name (Legal Business Name): DONNA L WHEELER MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7750 SW 60TH AVE STE E
OCALA FL
34476-6472
US

IV. Provider business mailing address

10137 NW 19TH PL
OCALA FL
34482-2507
US

V. Phone/Fax

Practice location:
  • Phone: 352-433-1918
  • Fax: 352-433-0950
Mailing address:
  • Phone: 352-875-4143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT19676
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: