Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | CH0006667 | FL |
NPI | 1598739930 |
---|---|
Provider Name | Dr. Kirk J. Whitten |
First Address | Margate, FL 33073-3423 |
Second Address | Margate, FL 33073-3423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 12/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
380629400 | (05) | FL |
U51657 | (02) | FL |