Provider Demographics
NPI:1003993056
Name:WHALEN, LENIS E (DC)
Entity Type:Individual
Prefix:DR
First Name:LENIS
Middle Name:E
Last Name:WHALEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38124 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-3509
Mailing Address - Country:US
Mailing Address - Phone:813-782-6060
Mailing Address - Fax:813-780-8407
Practice Address - Street 1:38124 NORTH AVE
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-3509
Practice Address - Country:US
Practice Address - Phone:813-782-6060
Practice Address - Fax:813-780-8407
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5433111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22032Medicare ID - Type UnspecifiedCHIROPRACTOR