Provider Demographics
NPI:1417938739
Name:WESTAFER, ANITA S (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:S
Last Name:WESTAFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2569 GULF BREEZE PKWY
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-3043
Mailing Address - Country:US
Mailing Address - Phone:850-934-0932
Mailing Address - Fax:850-934-0737
Practice Address - Street 1:2569 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-3043
Practice Address - Country:US
Practice Address - Phone:850-934-0932
Practice Address - Fax:850-934-0737
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36003207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL17484OtherBCBS FL #
FL039503000Medicaid
FL039503000Medicaid
FL17484YMedicare ID - Type UnspecifiedMEDICARE #