Provider Demographics
NPI:1104913102
Name:WHELIHAN, MAUREEN (MD)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:
Last Name:WHELIHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 LAKE WORTH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2965
Mailing Address - Country:US
Mailing Address - Phone:561-965-9559
Mailing Address - Fax:561-964-9904
Practice Address - Street 1:6801 LAKE WORTH RD
Practice Address - Street 2:#100W
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467
Practice Address - Country:US
Practice Address - Phone:561-965-9559
Practice Address - Fax:561-964-9904
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066909207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE32892Medicare ID - Type Unspecified