Healthcare Provider Details

I. General information

NPI: 1831053222
Provider Name (Legal Business Name): STEVEN WHITED
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2529 LEEWARD WAY
WINTER PARK FL
32792-1624
US

IV. Provider business mailing address

2529 LEEWARD WAY
WINTER PARK FL
32792-1624
US

V. Phone/Fax

Practice location:
  • Phone: 502-428-9738
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA34380
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: