Healthcare Provider Details

I. General information

NPI: 1144984394
Provider Name (Legal Business Name): WHINNEY MATHEW PHILIP APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7031 SW 62ND AVE
SOUTH MIAMI FL
33143-4701
US

IV. Provider business mailing address

13499 BISCAYNE BLVD APT 1009
NORTH MIAMI FL
33181-2028
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7500
  • Fax:
Mailing address:
  • Phone: 215-375-4766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11016218
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: