Provider Demographics
NPI:1801828041
Name:MEYER, JOHN WESTAN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WESTAN
Last Name:MEYER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6813 SOUTH TAMIAMI TRAIL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231
Mailing Address - Country:US
Mailing Address - Phone:941-923-5861
Mailing Address - Fax:941-926-4547
Practice Address - Street 1:6813 SOUTH TAMIAMI TRAIL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231
Practice Address - Country:US
Practice Address - Phone:941-923-5861
Practice Address - Fax:941-926-4547
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57727207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270740300Medicaid
FL37780OtherBCBS
FLU2264YMedicare PIN
FL270740300Medicaid
FLP00387077Medicare PIN
E43811Medicare UPIN