Individual
BRUCE RANDOLPH WHITING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5221 EHRLICH RD STE A, TAMPA, FL 33624-2006
(813) 960-8378
Mailing address
3131 LAKESTONE DR, TAMPA, FL 33618-1120
(813) 962-4701
(813) 962-4701
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY3260
FL
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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