Provider Demographics
NPI:1336701267
Name:WHETZEL, CURTIS (DPT)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:
Last Name:WHETZEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8477 S SUNCOAST BLVD
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34446-5028
Mailing Address - Country:US
Mailing Address - Phone:352-382-7214
Mailing Address - Fax:352-382-7781
Practice Address - Street 1:8477 S SUNCOAST BLVD
Practice Address - Street 2:
Practice Address - City:HOMOSASSA
Practice Address - State:FL
Practice Address - Zip Code:34446-5028
Practice Address - Country:US
Practice Address - Phone:352-382-7214
Practice Address - Fax:352-382-7781
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31461225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty