Provider Demographics
NPI:1164859070
Name:DOCTOR ON WHEELS PLLC
Entity Type:Organization
Organization Name:DOCTOR ON WHEELS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:JUNIOR
Authorized Official - Last Name:TELUSMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-345-5336
Mailing Address - Street 1:5645 CORAL RIDGE DRIVE
Mailing Address - Street 2:SUITE 142
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5645 CORAL RIDGE DRIVE
Practice Address - Street 2:SUITE 142
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076
Practice Address - Country:US
Practice Address - Phone:954-345-5336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108006207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty