Healthcare Provider Details

I. General information

NPI: 1215874011
Provider Name (Legal Business Name): JOSHUA WHALEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 S DIXIE HWY, CORAL GABLES, FL 33146
CORAL GABLES FL
33146
US

IV. Provider business mailing address

10229 SW 77TH CT
MIAMI FL
33156-2686
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-2211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN9667502
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: