Individual
ANN LOUISE THREATTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1839 CENTRAL AVE, ST PETERSBURG, FL 33713-8900
(727) 322-1054
(727) 322-2725
Mailing address
1839 CENTRAL AVE, ST PETERSBURG, FL 33713
(727) 322-1054
(727) 322-2725
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS13704
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112765400
—
FL
01
—
H0JX6
BLUE CROSS
FL
Enumeration date
11/06/2013
Last updated
11/13/2023
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