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NPI Code Detail

MEDICARE: JENNIFER WHEELER P.A.

MEDICARE: JENNIFER WHEELER P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA9103459FL

General Provider Information

NPI Number : 1194950030
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER WHEELER P.A.
Provider Business Mailing Address
First Line : 1401 W SEMINOLE BLVD
Second Line : CENTRAL FLORIDA REGIONAL HOSPITAL
City : SANFORD
State : FL
Zip : 32771-6743
Country : US
Telephone Number : 407-321-4500
Fax Number :
Provider Business Practice Location Address
First Line : 1401 W SEMINOLE BLVD
Second Line : CENTRAL FLORIDA REGIONAL HOSPITAL
City : SANFORD
State : FL
Zip : 32771-6743
Country : US
Telephone Number : 407-321-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2009
Last Update Date : 03/23/2015

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