Provider Demographics
NPI:1902049182
Name:WEBSTER, JAMI S (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMI
Middle Name:S
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2001 COUNTY ROAD 210 W STE 200
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-2063
Mailing Address - Country:US
Mailing Address - Phone:044-508-1209
Mailing Address - Fax:904-230-1066
Practice Address - Street 1:2001 COUNTY ROAD 210 W STE 200
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-2063
Practice Address - Country:US
Practice Address - Phone:044-508-1209
Practice Address - Fax:904-230-1066
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103394208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003554500Medicaid