Provider Demographics
NPI:1932818671
Name:WILHELM, TAYLOR (DPT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:WILHELM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:800 TREASURE CAY DR APT 104
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-5359
Mailing Address - Country:US
Mailing Address - Phone:321-277-2028
Mailing Address - Fax:
Practice Address - Street 1:156 NW CALIFORNIA BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2492
Practice Address - Country:US
Practice Address - Phone:728-717-1707
Practice Address - Fax:772-871-9330
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT39708225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist