Individual
DALE A. WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8262 POINT MEADOWS DR STE 202, JACKSONVILLE, FL 32256-4700
(904) 265-4310
(833) 578-1807
Mailing address
705 WELLS RD STE 300, ORANGE PARK, FL 32073-2982
(904) 282-6331
(904) 619-1080
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME46812
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010025464
RAILROAD MEDICARE
FL
05
—
0428086-00
—
FL
Enumeration date
06/13/2005
Last updated
12/07/2022
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