Individual
DR. FELIPE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1401 16TH ST N, ST PETERSBURG, FL 33704-4123
(727) 291-7343
(727) 895-1215
Mailing address
3506 COASTAL DUSK DR, PLANT CITY, FL 33565-5943
(954) 547-0445
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO4014
FL
213EP1101X
Primary Podiatric Medicine Podiatrist
PO4014
FL
213ES0000X
Sports Medicine Podiatrist
PO4014
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO4014
FL
213ES0131X
Foot Surgery Podiatrist
PO4014
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106555400
—
FL
01
—
14673711
CAQH ID
—
01
—
XOQ6L
BCBS
FL
Enumeration date
03/31/2016
Last updated
06/13/2023
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