Provider Demographics
NPI:1437103520
Name:WESTBROOK, RAYMOND R JR (DO)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:R
Last Name:WESTBROOK
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 NW 13TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2269
Mailing Address - Country:US
Mailing Address - Phone:561-955-6663
Mailing Address - Fax:561-955-2879
Practice Address - Street 1:670 GLADES RD STE 300
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6464
Practice Address - Country:US
Practice Address - Phone:561-395-2626
Practice Address - Fax:561-750-3878
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS17989207R00000X
TXL0688207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045797005Medicaid
TX045797004Medicaid
TX045797003Medicaid
TX045797004Medicaid
TX8L5448Medicare PIN
TX8J6082Medicare PIN