Provider Demographics
NPI:1689681132
Name:WESTBERRY, KAREN R (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:R
Last Name:WESTBERRY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:10140 CENTURION PARKWAY N
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPARTMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0532
Mailing Address - Country:US
Mailing Address - Phone:904-697-4127
Mailing Address - Fax:904-697-5102
Practice Address - Street 1:840 37TH PL
Practice Address - Street 2:STE 1N
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6502
Practice Address - Country:US
Practice Address - Phone:772-978-9000
Practice Address - Fax:772-978-9922
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
FLME64071208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374379900Medicaid
FL23671VMedicare PIN
FLF72160Medicare UPIN