Provider Demographics
NPI:1285168773
Name:WHITFIELD, WHITNEY (MD)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:WHITFIELD
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 1:2535 CAPITAL MEDICAL BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4624
Mailing Address - Country:US
Mailing Address - Phone:850-877-7337
Mailing Address - Fax:850-877-8675
Practice Address - Street 1:2535 CAPITAL MEDICAL BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4624
Practice Address - Country:US
Practice Address - Phone:850-877-7337
Practice Address - Fax:850-877-8675
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME150354207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty