MEDICARE: JASMINE WESTBROOKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	7993	FL

General Provider Information

NPI Number	:	1669917019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE WESTBROOKS

Provider Business Mailing Address
First Line	:	4023 SUN N LAKE BLVD
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33872-2130
Country	:	US
Telephone Number	:	863-402-0177
Fax Number	:

Provider Business Practice Location Address
First Line	:	4023 SUN N LAKE BLVD
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33872-2130
Country	:	US
Telephone Number	:	863-402-0177
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2016
Last Update Date	:	12/21/2016

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