Individual
MOIRA GRACE ANTALEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-3333
Mailing address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/22/2024
Last updated
08/22/2024
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