MEDICARE: CHRISTOPHER HENRY WHITTWELL PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	9118572	FL

General Provider Information

NPI Number	:	1073370193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER HENRY WHITTWELL PA

Provider Business Mailing Address
First Line	:	5444 SW 149TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4018
Country	:	US
Telephone Number	:	305-283-7705
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 S STATE ROAD 7 STE 201
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33068-4033
Country	:	US
Telephone Number	:	754-229-6886
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2024
Last Update Date	:	03/05/2024

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