Healthcare Provider Details

I. General information

NPI: 1801581533
Provider Name (Legal Business Name): SHANEEN TASHNA MALEAK WHYTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6056 BOYNTON BEACH BLVD STE 115
BOYNTON BEACH FL
33437-3500
US

IV. Provider business mailing address

6056 W BOYNTON BEACH BLVD STE 115
BOYNTON BEACH FL
33437-3500
US

V. Phone/Fax

Practice location:
  • Phone: 561-708-1760
  • Fax:
Mailing address:
  • Phone: 954-830-3062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME175800
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: