Provider Demographics
NPI:1063823854
Name:VERO PEDIATRICS, PA
Entity Type:Organization
Organization Name:VERO PEDIATRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:R
Authorized Official - Last Name:WESTBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-978-9000
Mailing Address - Street 1:840 37TH PL
Mailing Address - Street 2:SUITE 1N
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6502
Mailing Address - Country:US
Mailing Address - Phone:772-978-9000
Mailing Address - Fax:
Practice Address - Street 1:840 37TH PL
Practice Address - Street 2:SUITE 1N
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6502
Practice Address - Country:US
Practice Address - Phone:772-978-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64071261QP2300X, 291U00000X
FLME78173291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256588900Medicaid
FL374379900Medicaid
FLG93350Medicare UPIN
FL256588900Medicaid