# DR. VIRGINIA BURNS PETITTO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1588624407
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME63378 | FL | Yes |

## Other

- **Enumeration date:** 03/24/2006
- **Last updated:** 07/16/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 18447 | BLUE CROSS BLUE SHIELD FL | FL |
| 01 | — | 18447Y | MEDICARE ID | FL |
| 05 | — | 371991000 | — | FL |