Provider Demographics
NPI:1245591114
Name:SCHUELER WHITEHEAD, AMBER ROSE (LMT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:ROSE
Last Name:SCHUELER WHITEHEAD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:ROSE
Other - Last Name:SCHUELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14546 OLD SAINT AUGUSTINE RD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5468
Mailing Address - Country:US
Mailing Address - Phone:904-296-1500
Mailing Address - Fax:904-391-1005
Practice Address - Street 1:14546 OLD SAINT AUGUSTINE RD
Practice Address - Street 2:SUITE 403
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5468
Practice Address - Country:US
Practice Address - Phone:904-296-1500
Practice Address - Fax:904-391-1005
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 62518225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist