Provider Demographics
NPI:1780148817
Name:WHATTS, PETER ELLIOT
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:ELLIOT
Last Name:WHATTS
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:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715-0459
Mailing Address - Country:US
Mailing Address - Phone:787-236-7543
Mailing Address - Fax:
Practice Address - Street 1:216 CALLE ISABEL
Practice Address - Street 2:MANSION REAL
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-236-7543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program