Healthcare Provider Details

I. General information

NPI: 1700079803
Provider Name (Legal Business Name): NANCY K WHELAN R.P.T., P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6724 FOREST HILL BLVD
GREENACRES FL
33413-3335
US

IV. Provider business mailing address

6724 FOREST HILL BLVD
GREENACRES FL
33413-3335
US

V. Phone/Fax

Practice location:
  • Phone: 561-433-2009
  • Fax:
Mailing address:
  • Phone: 561-433-2009
  • Fax: 561-433-1496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2137
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: