Provider Demographics
NPI:1295968485
Name:WHITFORD, ROBERT WINDELL (EDS)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WINDELL
Last Name:WHITFORD
Suffix:
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 W ALVA ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7033
Mailing Address - Country:US
Mailing Address - Phone:813-872-8022
Mailing Address - Fax:813-872-1530
Practice Address - Street 1:3910 W ALVA ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7033
Practice Address - Country:US
Practice Address - Phone:813-872-8022
Practice Address - Fax:813-872-1530
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH494101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health