Healthcare Provider Details

I. General information

NPI: 1134161425
Provider Name (Legal Business Name): CARL A WHEELER CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 RIDGELY AVE STE 201
ANNAPOLIS MD
21401-1083
US

IV. Provider business mailing address

9500 S DADELAND BLVD STE 200
MIAMI FL
33156-2866
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-4887
  • Fax: 410-224-1428
Mailing address:
  • Phone: 786-530-3820
  • Fax: 305-675-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR106283
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR106283
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: