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
Mailing address20 W. Kaley Street, Orlando, FL 32806-2931

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