Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | OS13461 | FL |
NPI | 1275772295 |
---|---|
Provider Name | Dr. John Louis Whitehead |
First Address | Bay Harbor Islands, FL 33154-2041 |
Second Address | Bay Harbor Islands, FL 33154-2041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2009 |
Last Update Date | 23/07/2020 |