Provider Demographics
NPI:1134255763
Name:WHITAKER, DAVID P (MSPT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:P
Last Name:WHITAKER
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 S INTERNATIONAL PKWY
Mailing Address - Street 2:STE 1321
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1402
Mailing Address - Country:US
Mailing Address - Phone:407-833-0802
Mailing Address - Fax:407-833-8931
Practice Address - Street 1:4512 CHAPMAN HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-4359
Practice Address - Country:US
Practice Address - Phone:865-577-7779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT18521225100000X
TN8889225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist