Individual
MARISSA KATHRYN WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RT (R)(MR)
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0111
Mailing address
7891 SW 82ND DR, GAINESVILLE, FL 32608-9524
(352) 514-3930
Taxonomy
Speciality
Code
Description
License number
State
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
CRT82658
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CRT82658
FLORIDA DEPARTMENT OF HEALTH
FL
Enumeration date
01/12/2022
Last updated
01/12/2022
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