Healthcare Provider Details

I. General information

NPI: 1477416188
Provider Name (Legal Business Name): DAVID WHEELER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 6TH ST S
ST PETERSBURG FL
33701-4814
US

IV. Provider business mailing address

4731 32ND AVE N
ST PETERSBURG FL
33713-2020
US

V. Phone/Fax

Practice location:
  • Phone: 727-893-6195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: