Provider Demographics
NPI:1972946606
Name:WHITTINGTON-GULBA, ALICE ANN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:ANN
Last Name:WHITTINGTON-GULBA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-958-5150
Mailing Address - Fax:954-958-5155
Practice Address - Street 1:6405 N FEDERAL HWY STE 401
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1421
Practice Address - Country:US
Practice Address - Phone:954-958-5150
Practice Address - Fax:954-958-5155
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11034008363LF0000X
AZAP4955363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily