Dylan Wiedeman, ATC,LAT

Athletic Trainer · Saint Augustine, FL

Individual Active NPI

NPI number 1699182584

Practice location

2024 E Clovelly Ln
Saint Augustine, FL 32092-1093
Phone
(904) 495-4485

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NPI record

NPI
1699182584
Entity type
Individual (Type 1)
Enumeration date
July 13, 2014
Last updated
July 13, 2014
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Athletic Trainer Primary 2255A2300X AL 3846 FL

About Dylan Wiedeman

Dylan Wiedeman, ATC,LAT is a healthcare provider registered in the NPI registry with the primary taxonomy Athletic Trainer (code 2255A2300X). The practice location is 2024 E Clovelly Ln, Saint Augustine, FL 32092-1093. The NPI number 1699182584 was assigned on July 13, 2014 and the record was last updated on July 13, 2014.

Dylan Wiedeman lists a license in the registry: #AL 3846 (FL) for Athletic Trainer. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Dylan Wiedeman, ATC,LAT?

The NPI number is 1699182584.

What is the phone number of Dylan Wiedeman?

The phone number listed for the practice location is (904) 495-4485.

Where is Dylan Wiedeman located?

2024 E Clovelly Ln, Saint Augustine, FL 32092-1093.

What is the taxonomy code for Dylan Wiedeman?

The primary taxonomy code is 2255A2300X – Athletic Trainer.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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