Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | ME120419 | FL |
NPI | 1114241213 |
---|---|
Provider Name | Jeffrey A Westerfield |
First Address | Temple Terrace, FL 33637-0925 |
Second Address | Tampa, FL 33625-4013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2010 |
Last Update Date | 14/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
012698300 | (05) | FL |
14WE0 | BCBS (01) | FL |
375876 | AVMED (01) | FL |
4160191 | AETNA (01) | FL |
4629631 | CIGNA (01) | FL |