Provider Demographics
NPI:1689639882
Name:WHITMAN, WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:WHITMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-3583
Mailing Address - Country:US
Mailing Address - Phone:352-315-7100
Mailing Address - Fax:352-360-6582
Practice Address - Street 1:201 E MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-3583
Practice Address - Country:US
Practice Address - Phone:352-357-1500
Practice Address - Fax:352-360-6582
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 372962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259853100Medicaid
FL79797OtherBLUE CROSS BLUE SHIELD #
FL79797OtherBLUE CROSS BLUE SHIELD #
BW5740318OtherDEA #
FL79797BMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER