1245299098 NPI number — AUTHRINE CHEVANNE WHYTE MD PHD

Table of content: (NPI 1992914071)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245299098 NPI number — AUTHRINE CHEVANNE WHYTE MD PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHYTE
Provider First Name:
AUTHRINE
Provider Middle Name:
CHEVANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245299098
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11140 W COLONIAL DR STE 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OCOEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34761-3300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-877-6500
Provider Business Mailing Address Fax Number:
321-203-4612

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11140 W COLONIAL DR STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OCOEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34761-3300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-877-6500
Provider Business Practice Location Address Fax Number:
321-203-4612
Provider Enumeration Date:
03/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  A90434 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: ME90864 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 275441000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 124870000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 28799 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1326256 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 3964664 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 103149200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com