Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kerry Whitaker, PA

Individual provider Physician Assistant · NPI 1164405114

Kerry Whitaker, PA is a Physician Assistant in Orlando, Florida. Works from 2 locations. Licensed in Alabama and Florida.

Licensed in
AL, FL
In the registry since
2005
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

20 W Kaley St
Orlando, FL 32806-2931
Phone: (407) 423-2581
Fax: (407) 849-6470
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 200 San Sebastian Vw, Saint Augustine, FL 32084-8695 — (904) 209-3250

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA3516 (FL)
Physician Assistant Taxonomy 363A00000X · Licence PA 484 (AL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PAX00002031 (FL)

Record details

NPI number1164405114
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 23, 2005
Last updated in NPPESApril 25, 2018

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