Provider Demographics
NPI:1972579290
Name:WEBBER, CAROLYN (DO)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:WEBBER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:KEHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4200 W CYPRESS ST STE 900
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-4173
Mailing Address - Country:US
Mailing Address - Phone:727-899-1096
Mailing Address - Fax:
Practice Address - Street 1:4200 W CYPRESS ST STE 900
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-4173
Practice Address - Country:US
Practice Address - Phone:813-506-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS07001207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271737900Medicaid
F05534Medicare UPIN
FL57133YMedicare PIN