Provider Demographics
NPI:1689783854
Name:WHRITENOUR, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:WHRITENOUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 S OCEAN BLVD
Mailing Address - Street 2:APT 103
Mailing Address - City:HIGHLAND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2505
Mailing Address - Country:US
Mailing Address - Phone:407-493-0695
Mailing Address - Fax:
Practice Address - Street 1:20401 STATE ROAD 7
Practice Address - Street 2:G 5/6
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6794
Practice Address - Country:US
Practice Address - Phone:561-482-8422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT19496OtherLICENSE #