Healthcare Provider Details

I. General information

NPI: 1114550423
Provider Name (Legal Business Name): WHC WPB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2020
Last Update Date: 02/14/2020
Certification Date: 02/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N FLORIDA MANGO RD
WEST PALM BEACH FL
33409-5214
US

IV. Provider business mailing address

1685 TARGET CT STE 15
FORT MYERS FL
33905-4926
US

V. Phone/Fax

Practice location:
  • Phone: 561-242-6405
  • Fax:
Mailing address:
  • Phone: 239-265-1891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: TERRY O'TOOLE
Title or Position: REGIONAL VP
Credential:
Phone: 816-512-5514