Provider Demographics
NPI:1790213379
Name:MANGES, WHITNEY MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:MARIE
Last Name:MANGES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:MARIE
Other - Last Name:MATHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:709 S HARBOR CITY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-1936
Mailing Address - Country:US
Mailing Address - Phone:321-725-2225
Mailing Address - Fax:321-802-5804
Practice Address - Street 1:2030 S PATRICK DR STE 3
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4400
Practice Address - Country:US
Practice Address - Phone:321-802-5810
Practice Address - Fax:321-802-5811
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist