MR. MARK WHITEHEAD (NPI# 1609162080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609162080 |
| Entity Type | Individual |
| Full Name | MR. MARK WHITEHEAD |
| Credential | PA-C |
| Practice Address |
7243 Della Dr Orlando FL 32819-5104 |
| Practice Telephone | 4076496878 |
| Practice Fax Number | 4074231380 |
| Mailing Telephone | 4076496878 |
| Mailing Fax Number | 4074231380 |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2018-11-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9106022 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 004300300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235326059 | Mark A. Whitehead | Pediatrics | 1222 Trotwood Ave., Ste 108, Columbia, TN 38401 | 2007-09-25 |
| 1255447314 | Mark L Whitehead | Psychologist | 642 S Alameda, Las Cruces, NM 88005 | 2006-08-22 |
| 1902869456 | Mark D Whitehead | Chiropractor | 2103 W Main St, Marion, IL 62959-1163 | 2006-04-07 |
| Street Address |
7243 DELLA DR |
| City | ORLANDO |
| State | FL |
| Zip Code | 32819-5104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275521882 | Nora A. Erhart | Internal Medicine | 7243 Della Dr, Orlando, FL 32819-5104 | 2005-10-07 |
| 1376106443 | Andre M Daley | Physician Assistant | 7243 Della Dr, Orlando, FL 32819-5104 | 2019-04-15 |
| 1023551041 | Ohri, LLC | Clinic/Center | 7243 Della Dr, Suite C, Orlando, FL 32819 | 2016-11-22 |
| 1861757734 | Michele L Young | Physician Assistant | 7243 Della Dr, Orlando, FL 32819-5104 | 2012-07-06 |
| 1932150562 | Ayman Ahmad Daouk | Orthopaedic Surgery | 7243 Della Dr, Orlando, FL 32819-5104 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093356842 | Crew Community Health, Inc | Internal Medicine | 8601 Commodity Circle, Orlando, FL 32819 | 2019-10-03 |
| 1437704756 | Byron Martin Randolph | Physical Therapist | 7932 Sand Lake Rd Ste 203, Orlando, FL 32819 | 2019-08-04 |
| 1225536303 | Alliance Dme LLC | Durable Medical Equipment & Medical Supplies | 7031 Grand National Dr Ste 106b, Orlando, FL 32819 | 2018-01-24 |
| 1417465584 | Marckenson Gerson Janvier | Nurse Practitioner | 9401 Turkey Lake Rd, Orlando, FL 32819 | 2018-01-11 |
| 1871003442 | Sabeen Hasni | Pharmacist | 2354 Commerce Park Drive Ste 100, Orlando, FL 32819 | 2017-10-09 |
| 1902343775 | Darleen Walker | Occupational Therapist | 7243 Della Dr., Orlando, FL 32819 | 2017-01-31 |
| 1215483565 | Krista Richardson | Physical Therapist | 9102 Universal Blvd., Orlando, FL 32819 | 2016-08-28 |
| 1841646536 | Kiara Serrano | Social Worker | 7509 Pinemount Dr, Orlando, FL 32819 | 2016-05-11 |
| 1659749752 | Angels for Kids On-call | Case Management | 7550 Future Drive Suite 105, Orlando, FL 32819 | 2015-09-04 |
| 1932589462 | Krista Jean Cain | Counselor | 7758 Wallace Rd Ste Vi, Orlando, FL 32819 | 2015-05-29 |
| Find all providers in zip 32819 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811559578 | Sydney Gillen | Physician Assistant | 1222 S Orange Ave Fl 2, Orlando, FL 32806-1215 | 2019-07-02 |
| 1750843405 | Heather Louise Anderson | Physician Assistant | 5422 Lewiston St, Orlando, FL 32812 | 2019-04-02 |
| 1649600891 | Raul F Velez | Physician Assistant | 14139 Budworth Cir, Orlando, FL 32832-6123 | 2013-11-24 |
| 1255630075 | Joleen Chapman | Physician Assistant | 122 Annie St, Orlando, FL 32806-1214 | 2011-03-18 |
| 1124354600 | Tiffany M Murray | Physician Assistant | 83 W Copeland Dr, Orlando, FL 32806-2002 | 2009-10-19 |
| 1225277825 | M Catherine Broderick | Physician Assistant | 1720 S Cook Avenue, Orlando, FL 32808 | 2009-02-05 |
| 1033360938 | Monica M Rivera | Physician Assistant | 2591 Carrickton Cir, Orlando, FL 32824-4217 | 2008-10-09 |
| 1316104383 | Michele D Young | Physician Assistant | 3802 Oakwater Cir Ste 3, Orlando, FL 32806-6200 | 2008-05-19 |
| 1033162011 | Southeastern Clinical Services,inc. | Physician Assistant | 4215 Edgewater, Orlando, FL 32804 | 2006-05-18 |
| 1386696631 | Kevin P Kingsley | Physician Assistant | 2501 N Orange Ave Ste 411, Orlando, FL 32804-4644 | 2006-05-16 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.