Healthcare Provider Details

I. General information

NPI: 1427372721
Provider Name (Legal Business Name): KHALILAH WESTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KHALILAH BROWN M.D.

II. Dates (important events)

Enumeration Date: 03/16/2010
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 16TH ST N
ST PETERSBURG FL
33705
US

IV. Provider business mailing address

900 CARILLON PKWY STE 301
ST PETERSBURG FL
33716-1115
US

V. Phone/Fax

Practice location:
  • Phone: 727-230-3423
  • Fax: 217-636-3056
Mailing address:
  • Phone: 727-230-3423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME118400
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberME118400
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME118400
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: