Provider Demographics
NPI:1679730600
Name:WHITTAKER, URSULA DANIELLE FLOYD (PT)
Entity type:Individual
Prefix:
First Name:URSULA
Middle Name:DANIELLE FLOYD
Last Name:WHITTAKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 SW 103RD CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-7145
Mailing Address - Country:US
Mailing Address - Phone:352-378-2955
Mailing Address - Fax:
Practice Address - Street 1:7135 NW 11TH PL
Practice Address - Street 2:SUITE B-3
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3143
Practice Address - Country:US
Practice Address - Phone:352-331-9356
Practice Address - Fax:352-331-9357
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23010225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist