Provider Demographics
NPI:1124391149
Name:WHEELER, MARERIL
Entity Type:Individual
Prefix:DR
First Name:MARERIL
Middle Name:
Last Name:WHEELER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 BAY RD
Mailing Address - Street 2:APARTMENT 2910
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-3399
Mailing Address - Country:US
Mailing Address - Phone:203-494-1515
Mailing Address - Fax:
Practice Address - Street 1:1504 BAY RD
Practice Address - Street 2:APARTMENT 2910
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-3399
Practice Address - Country:US
Practice Address - Phone:203-494-1515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD18318207P00000X
NY268540-1207P00000X
SC38878207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine