Provider Demographics
NPI:1811045230
Name:WESTHEAD, VALERIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANN
Last Name:WESTHEAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:VALERIE
Other - Middle Name:WEASTHEAD
Other - Last Name:TONNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:216 HEATHERWOOD COURT
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708
Mailing Address - Country:US
Mailing Address - Phone:407-359-1740
Mailing Address - Fax:407-365-6044
Practice Address - Street 1:300 BAY AVENUE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771
Practice Address - Country:US
Practice Address - Phone:407-321-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME773432084P0800X
WI271122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31433800Medicaid
FLE2397ZMedicare ID - Type Unspecified
WI02341Medicare ID - Type Unspecified
B57576Medicare UPIN