Wilson Shulterbrandt Holdings, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

WILSON SHULTERBRANDT HOLDINGS, LLC

Doing business as

The Anti-Aging Clinic of Northwest Florida

Practice address

13569 Panama City Beach Pkwy
Panama City Beach, FL 32407-2847

Phone

(850) 238-8563

Fax

(850) 238-8564

NPI assigned

Apr 1, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angel Shulterbrandt

Title

Co-Owner

Phone

(985) 517-4561

Specialties & licenses 1

Addresses

Other names 1

• The Anti-Aging Clinic of Northwest Florida Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743465600000",
    "number": "1912701830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 CHARLES CT",
            "city": "CHALMETTE",
            "state": "LA",
            "postal_code": "700432615",
            "telephone_number": "985-517-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13569 PANAMA CITY BEACH PKWY",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072847",
            "telephone_number": "850-238-8563",
            "fax_number": "850-238-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON SHULTERBRANDT HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A",
        "authorized_official_last_name": "SHULTERBRANDT",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "985-517-4561"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Anti-Aging Clinic of Northwest Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Todd Wilhelm, COTA/L
• Catherine Williams
• Freda Williams, CCC-SLP
• Jordan Williams
• Jodi S Wilmot, MPH OTR/L
• Jessica Wilson
• Vicky Diane Wofford, M.A.
• Laura Wolfe
• John William Woltz, D.O.
• Rachael Wommack

• Clinic/Center in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.