Provider Demographics
NPI:1568492601
Name:KROHN, WHITNEY LEIGH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:LEIGH
Last Name:KROHN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2999 NE 191ST STREET
Mailing Address - Street 2:PH 1
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3116
Mailing Address - Country:US
Mailing Address - Phone:305-933-1151
Mailing Address - Fax:
Practice Address - Street 1:2999 NE 191ST STREET
Practice Address - Street 2:PH 1
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3116
Practice Address - Country:US
Practice Address - Phone:305-933-1151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102955363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
U5569ZMedicare ID - Type Unspecified
Q50495Medicare UPIN