Provider Demographics
NPI:1174649388
Name:WESTER, JUAN SVEN AAGE (MD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:SVEN AAGE
Last Name:WESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5015 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6515
Mailing Address - Country:US
Mailing Address - Phone:954-962-7172
Mailing Address - Fax:954-962-7199
Practice Address - Street 1:5015 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6515
Practice Address - Country:US
Practice Address - Phone:954-962-7172
Practice Address - Fax:954-962-7199
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0012185208600000X
GA011201208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1000279OtherCARE PLUS
FL0589152OtherAETNA HMO
FL4404981OtherAETNA PPO
FL223115OtherAV MED
FL3984211OtherCIGNA HEALTHCARE
FL06580OtherBLUE CROSS BLUE SHIELD
FL1702226OtherUNITED HEALTH CARE
FL0589152OtherAETNA HMO
FL1000279OtherCARE PLUS