Basic Information
Provider Information
NPI: 1487647772
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHINNEN
FirstName: DANIEL
MiddleName: WILLIAM
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1020 LAKE SUMTER LNDG
Address2:  
City: THE VILLAGES
State: FL
PostalCode: 321622699
CountryCode: US
TelephoneNumber: 3526748700
FaxNumber:  
Practice Location
Address1: 1400 N US HIGHWAY 441 STE 810
Address2:  
City: THE VILLAGES
State: FL
PostalCode: 321598987
CountryCode: US
TelephoneNumber: 3526748700
FaxNumber: 3526748714
Other Information
ProviderEnumerationDate: 08/23/2005
LastUpdateDate: 02/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XME0060280FLY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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