Provider Demographics
NPI:1467608877
Name:WEST, JARED HUNTER (MD)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:HUNTER
Last Name:WEST
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 1:946 EAST SEMORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5633
Mailing Address - Country:US
Mailing Address - Phone:407-831-3141
Mailing Address - Fax:407-831-7873
Practice Address - Street 1:946 EAST SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5633
Practice Address - Country:US
Practice Address - Phone:407-831-3141
Practice Address - Fax:407-831-7873
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRS2006-0433207R00000X
FLME156430207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine