Individual
DR. BRIAN LAWRENCE MAVRETICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6333 54TH AVE N, ST PETERSBURG, FL 33709-1703
(727) 548-6100
(727) 497-2322
Mailing address
4385 48TH AVE S, ST PETERSBURG, FL 33711-4611
(248) 420-9942
(727) 497-2322
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS17981
FL
208VP0014X
Interventional Pain Medicine Physician
OS17981
FL
Other
Enumeration date
05/15/2017
Last updated
01/24/2024
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