Healthcare Provider Details

I. General information

NPI: 1427985100
Provider Name (Legal Business Name): AMANDA WEHLE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9079 BELCHER RD N
PINELLAS PARK FL
33782-4423
US

IV. Provider business mailing address

2805 87TH PL N APT 304
PINELLAS PARK FL
33782-6226
US

V. Phone/Fax

Practice location:
  • Phone: 727-616-0809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT40740
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: