Individual
EVELENA COUSIN-PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, MDC 41, TAMPA, FL 33612-4742
(813) 844-7412
(813) 974-8359
Mailing address
5520 VINTAGE VIEW PASS, LAKELAND, FL 33812-4061
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME138727
FL
Other
Enumeration date
04/11/2013
Last updated
08/01/2025
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