Provider Demographics
NPI:1336703065
Name:WESTER, TYLER X (DO)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:X
Last Name:WESTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 ATLANTIC BLVD STE 11
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-8245
Mailing Address - Country:US
Mailing Address - Phone:904-775-3138
Mailing Address - Fax:866-493-3448
Practice Address - Street 1:9400 ATLANTIC BLVD STE 11
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-8245
Practice Address - Country:US
Practice Address - Phone:904-775-3138
Practice Address - Fax:866-493-3448
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOCN6207Q00000X
FLOCN5207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty