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Dale Alan Whitaker JR.
Student in an Organized Health Care Education/Training Program in Orange Park, Florida
NPI 1124720776

Dale Alan Whitaker JR. is a Student in an Organized Health Care Education/Training Program based in Orange Park, FL. Dale Alan Whitaker JR. practices in Orange Park, FL. The NPI Number for Dale Alan Whitaker JR. is 1124720776 and holds a License No. (Florida).

The current practice location address for Dale Alan Whitaker JR. is 2001 Kingsley Ave, Orange Park, FL and can be reached out via phone at 904-639-2112.

Location: 2001 Kingsley Ave, Orange Park, FL, 32073-5148
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1124720776
Provider Name
Dale Alan Whitaker JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
2001 Kingsley Ave, Orange Park, FL, 32073-5148
Phone Number
904-639-2112
Fax Number
Provider Enumeration Date
03/20/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2001 Kingsley Ave
City
Orange Park
State
Florida
Zip
32073-5148
Phone Number
904-639-2112
Fax Number
person
Provider Business Mailing Address Details
Address
2001 Kingsley Ave
City
Orange Park
State
Florida
Zip
32073-5148
Phone Number
904-639-2112
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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