Provider Demographics
NPI:1427043173
Name:NANCY K. WHELAN,R.P.T.,P.A.
Entity type:Organization
Organization Name:NANCY K. WHELAN,R.P.T.,P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:K
Authorized Official - Last Name:WHELAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPT, PA
Authorized Official - Phone:561-433-2009
Mailing Address - Street 1:6724 FOREST HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33413-3335
Mailing Address - Country:US
Mailing Address - Phone:561-433-2009
Mailing Address - Fax:561-433-1496
Practice Address - Street 1:6714 FOREST HILL BLVD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413-3335
Practice Address - Country:US
Practice Address - Phone:561-433-2009
Practice Address - Fax:561-433-1496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 2137225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4440OtherMEDICARE PTAN
FLK4440OtherMEDICARE PTAN