Provider Demographics
NPI:1588897847
Name:ROBERT WESTHEIMER DC PA
Entity type:Organization
Organization Name:ROBERT WESTHEIMER DC PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WESTHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-722-0500
Mailing Address - Street 1:4507 N PINE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5321
Mailing Address - Country:US
Mailing Address - Phone:954-722-0500
Mailing Address - Fax:954-742-0583
Practice Address - Street 1:4507 N PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-5321
Practice Address - Country:US
Practice Address - Phone:954-722-0500
Practice Address - Fax:954-742-0583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2850111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051058100Medicaid
FLDD058AMedicare PIN
FL051058100Medicaid