Individual
MISS DESTINY SUE O'NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
455 PINELLAS ST STE 320, CLEARWATER, FL 33756-3369
(727) 446-2273
(727) 441-4966
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 532-1355
(813) 635-2613
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9104018
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110868700
—
FL
Enumeration date
07/06/2012
Last updated
04/25/2023
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