Healthcare Provider Details

I. General information

NPI: 1114241213
Provider Name (Legal Business Name): JEFFREY A WESTERFIELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2010
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6619 N WICKHAM RD
MELBOURNE FL
32940-2006
US

IV. Provider business mailing address

13020 N TELECOM PKWY
TEMPLE TERRACE FL
33637-0925
US

V. Phone/Fax

Practice location:
  • Phone: 321-259-9500
  • Fax: 321-253-1777
Mailing address:
  • Phone: 813-978-9700
  • Fax: 813-558-6186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberME120419
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: