Provider Demographics
NPI:1972565091
Name:ANITA S. WESTAFER, M.D., P.A.
Entity Type:Organization
Organization Name:ANITA S. WESTAFER, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WESTAFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-934-0932
Mailing Address - Street 1:2569 GULF BREEZE PKWY
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-3043
Mailing Address - Country:US
Mailing Address - Phone:850-934-0932
Mailing Address - Fax:850-934-0737
Practice Address - Street 1:2569 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-3043
Practice Address - Country:US
Practice Address - Phone:850-934-0932
Practice Address - Fax:850-934-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36003207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME36003OtherFLORIDA MEDICAL LICENSE NUMBER
FL263385000Medicaid
FL34928OtherBCBS FLORIDA GROUP #
FLME36003OtherFLORIDA MEDICAL LICENSE NUMBER