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General NPI Number Information
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NPI Number | 1346819620
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Entity Type | Individual
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Provider Name | WHITNEY LYNN DESOTELL MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 06/22/2021
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 5650 BOLLETTIERI BLVD
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City | BRADENTON
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State | FL
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Zip | 34210-2211
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Country | US
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Telephone | 941-807-5030
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Fax |
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Provider Business Mailing Address
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Address Line | 969 LANTERN LIGHT CT
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City | TALLAHASSEE
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State | FL
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Zip | 32312-9008
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Country | US
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Telephone | 850-459-1704
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL7406
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License Number State | FL
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