MEDICARE: NANCY K. WHELAN,R.P.T.,P.A.

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	225100000X	Physical Therapist	PT 2137	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K4440	OTHER	FL	MEDICARE PTAN

General Provider Information

NPI Number	:	1427043173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NANCY K. WHELAN,R.P.T.,P.A.

Provider Business Mailing Address
First Line	:	6724 FOREST HILL BLVD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33413-3335
Country	:	US
Telephone Number	:	561-433-2009
Fax Number	:	561-433-1496

Provider Business Practice Location Address
First Line	:	6714 FOREST HILL BLVD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33413-3335
Country	:	US
Telephone Number	:	561-433-2009
Fax Number	:	561-433-1496

Authorized Official
Title or Position	:	OWNER
Name	:	MS. NANCY K WHELAN
Credential	:	R.P.T., P.A.
Telephone Number	:	561-433-2009

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	06/07/2016

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