Individual
FELICIA LAVERNE BRISTOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2549 15TH AVE S, SAINT PETERSBURG, FL 33712-2150
(727) 686-1689
Mailing address
2549 15TH AVE S, SAINT PETERSBURG, FL 33712-2150
(727) 686-1689
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
L21000139942
FL
Other
Enumeration date
12/02/2025
Last updated
12/02/2025
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