Healthcare Provider Details

I. General information

NPI: 1962737627
Provider Name (Legal Business Name): KARI LYNN WHITMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARI L HAZELWOOD PA-C

II. Dates (important events)

Enumeration Date: 10/13/2009
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AVENUE I NE
WINTER HAVEN FL
33881-4143
US

IV. Provider business mailing address

4371 DIAMOND RD
WINTER HAVEN FL
33880-1503
US

V. Phone/Fax

Practice location:
  • Phone: 863-680-7214
  • Fax: 866-264-8519
Mailing address:
  • Phone: 863-680-7000
  • Fax: 866-264-8519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9105177
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: