Individual
DR. MARK LYLE WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1223 GATEWAY DR STE 2G, MELBOURNE, FL 32901-2607
(321) 312-3497
(321) 768-5082
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101022241
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
OS18501
FL
207RP1001X
Pulmonary Disease Physician
Primary
OS18501
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114293700
—
FL
01
—
PH033
HF MA
FL
Enumeration date
05/06/2016
Last updated
11/06/2023
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