MEDICARE: MS. WHITNEY LEIGH KROHN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA9102955	FL

General Provider Information

NPI Number	:	1568492601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. WHITNEY LEIGH KROHN PA-C

Provider Business Mailing Address
First Line	:	2999 NE 191ST STREET
Second Line	:	PH 1
City	:	AVENTURA
State	:	FL
Zip	:	33180-3116
Country	:	US
Telephone Number	:	305-933-1151
Fax Number	:

Provider Business Practice Location Address
First Line	:	2999 NE 191ST STREET
Second Line	:	PH 1
City	:	AVENTURA
State	:	FL
Zip	:	33180-3116
Country	:	US
Telephone Number	:	305-933-1151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	01/11/2011

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