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Individual

MICHAEL L. WHITWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5380 TECH DATA DR, CLEARWATER, FL 33760-3122
(727) 573-7777
(727) 573-7710
Mailing address
PO BOX 17426, CLEARWATER, FL 33762-0426
(727) 573-7777
(727) 573-7710

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME112089
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
IO665Z
MEDICARE PTAN
FL
Enumeration date
08/10/2005
Last updated
10/28/2019
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