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Individual
DR. JAMES ERIC PETERZELL
Active
Individual
DR. JAMES ERIC PETERZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS11883
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11752185
CAQH ID#
—
01
—
1487623187
PROVIDER NPI
—
01
—
59-3465993
TAX ID #
FL
01
—
GW524Z
MEDICARE PTAN
FL
01
—
I66179
UPIN
FL
01
—
OS11883
STATE LICENSE
FL
Enumeration date
03/15/2006
Last updated
02/07/2024
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