MEDICARE: WHITNEY LAPOLLA DELOZIER MD

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	207N00000X	Dermatology Physician	ME122426	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770726499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY LAPOLLA DELOZIER MD

Provider Business Mailing Address
First Line	:	4651 VAN DYKE RD
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-4880
Country	:	US
Telephone Number	:	813-321-1786
Fax Number	:	813-321-1787

Provider Business Practice Location Address
First Line	:	8787 BRYAN DAIRY RD STE 360
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33777-1260
Country	:	US
Telephone Number	:	727-393-4900
Fax Number	:

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

Provider Enumeration Date	:	04/10/2009
Last Update Date	:	10/11/2023

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