Provider Demographics
NPI:1851387906
Name:WESTERVELT, JAMES A (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:WESTERVELT
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 1:601 7TH ST S STE 495
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4746
Mailing Address - Country:US
Mailing Address - Phone:727-289-5980
Mailing Address - Fax:727-289-5980
Practice Address - Street 1:601 7TH ST S STE 495
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4746
Practice Address - Country:US
Practice Address - Phone:727-289-5980
Practice Address - Fax:727-289-5980
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92565208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272070100Medicaid
FL01543YMedicare PIN
FL272070100Medicaid