Individual
COLEY LAUREN WESTERBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1033 MARTIN LUTHER KING STREET NORTH, SUITE 108, ST PETERSBURG, FL 33701
(727) 215-9295
Mailing address
8540 42ND AVE N, ST PETERSBURG, FL 33709-3951
(727) 215-9295
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9106166
FL
Other
Enumeration date
09/30/2011
Last updated
09/30/2011
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