MEDICARE: WHELAN W CULLEY III 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	207Q00000X	Family Medicine Physician	ME42533	FL

General Provider Information

NPI Number	:	1801908868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHELAN W CULLEY III MD

Provider Business Mailing Address
First Line	:	10850 TEMPLE TER 300
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33772-4869
Country	:	US
Telephone Number	:	727-398-5295
Fax Number	:	727-391-2742

Provider Business Practice Location Address
First Line	:	8211 113TH ST
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33772-4128
Country	:	US
Telephone Number	:	727-398-5295
Fax Number	:	727-391-2742

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	10/06/2015

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