Individual
RADIAH MYRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 78TH AVE N APT 73, ST PETERSBURG, FL 33702-4466
(727) 712-7661
Mailing address
200 78TH AVE N APT 73, ST PETERSBURG, FL 33702-4466
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
120806
FL
405300000X
Prevention Professional
Primary
120806
FL
Other
Enumeration date
03/22/2017
Last updated
03/22/2017
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