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Individual

MRS. MICHELLE BERTHELOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
524 HIGHLAND ST N, ST PETERSBURG, FL 33701-2120
(727) 827-4778
(727) 827-4779
Mailing address
524 HIGHLAND ST N, ST PETERSBURG, FL 33701-2120
(727) 827-4778
(727) 827-4779

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
AL10104
FL
372600000X
Adult Companion

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141913700
FL
Enumeration date
01/05/2014
Last updated
01/05/2014
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