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Individual

HAROLD ROBERT WHITLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
11406 BALM RIVERVIEW RD, RIVERVIEW, FL 33569-6215
(813) 671-2833
(813) 671-2833
Mailing address
11406 BALM RIVERVIEW RD, RIVERVIEW, FL 33569-6215
(813) 671-2833
(813) 671-2833

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
230490200
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
230490200
FL
Enumeration date
04/30/2008
Last updated
04/30/2008
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